170: Payment is denied when performed/billed by this type of provider.
This particular category of provider, whether by specialty, license type, or facility type, is not permitted to bill for this service under the payer's rules, regardless of whether the service itself is covered for someone else.
What the group code means
- CO
- Contractual Obligation. The provider is responsible and the amount cannot be billed to the patient.
Why it fires
- The payer restricts this code to specific specialties or provider types and the billing provider does not qualify
- The service was billed under the wrong provider's NPI, such as when a supervising physician should have billed instead of the technician
- State scope-of-practice or payer credentialing rules exclude this provider type from this service
Corrective actions, ranked
- 1
Confirm provider type rules
Check the payer's policy on which provider types or specialties may bill this code.
- 2
Rebill under the correct provider
If a different, qualified provider actually performed or supervised the service, correct the rendering provider and resubmit.
- 3
Check credentialing
If the provider should be eligible but is denied, verify their specialty or taxonomy is correctly loaded with the payer.
Is it worth appealing
Appeal when the rendering provider is in fact credentialed and eligible for this service type but was denied due to a taxonomy or enrollment data error on the payer's end.
Retrieved 2026-07-18.
Do not let this happen again
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DenialPath provides billing and administrative guidance based on published CMS and X12 sources. It is not medical advice, not a coverage determination, and not a guarantee of payment. NCCI and MUE edits are republished quarterly and payer policies vary by contract. Always confirm against the payer's own current policy before submitting or appealing.