CO-97: Bundled into another service
Triage: Correct and resubmit
By Dr. Daniel Turner, DC · Reviewed September 2, 2026
What does denial code CO-97 mean?
The payer considers this service part of another service billed the same day, so it paid nothing separately.
What does CO-97 usually mean in a chiropractic office?
This is the most chiropractic denial there is: 97140 manual therapy billed the same day as a CMT adjustment without a 59 or XS modifier showing it was a distinct service on a separate region. Exams billed with adjustments without a 25 modifier produce the same result.
How do you fix a CO-97 denial?
- Confirm the two services truly were distinct: different region, separate time, documented separately.
- If distinct, add 59 or XS to 97140, or 25 to the exam, and resubmit as corrected.
- If not distinct, the bundling is correct and the line is a write off. Do not bill the patient for a bundled line.
What this looks like in practice
A patient gets a four region adjustment and fifteen minutes of manual therapy on the neck, documented as distinct work on a separate region. The claim goes out as 98942 plus 97140 with no modifier. The payer bundles the 97140 into the CMT and pays nothing for it. With the 59 or XS modifier and region separation documented, the same claim pays both lines.
What the authorities say
The 97140 with CMT combination is governed by the National Correct Coding Initiative procedure to procedure edits, which define when two services billed together are payable separately and which modifiers can appropriately break the pair.
How to stop it from happening again
- ✓Check NCCI bundling pairs at claim creation, before submission
- ✓Document region and time separation for manual therapy on the same visit as CMT
- ✓Only unbundle services that genuinely were distinct; a modifier on bundled work is a payback waiting to happen
Appeal language that works for CO-97
A starting paragraph in the wording reviewers expect. Replace the bracketed pieces with the claim's own facts and attach the records it references.
How Cervica handles CO-97
The scrubber checks NCCI bundling pairs before submission and the denial worklist suggests the exact modifier remedy when a bundling denial comes back on the ERA.
Related codes
- →CO-4 · Procedure code inconsistent with the modifier
- →CO-16 · Claim lacks information
- →97140 · the CPT side of this denial
- →Modifier 59 / XS · the CPT side of this denial
Quick answers
What does denial code CO-97 mean?
The payer considers this service part of another service billed the same day, so it paid nothing separately.
What does CO-97 usually mean in a chiropractic office?
This is the most chiropractic denial there is: 97140 manual therapy billed the same day as a CMT adjustment without a 59 or XS modifier showing it was a distinct service on a separate region. Exams billed with adjustments without a 25 modifier produce the same result.
How do you fix a CO-97 denial?
Confirm the two services truly were distinct: different region, separate time, documented separately. If distinct, add 59 or XS to 97140, or 25 to the exam, and resubmit as corrected. If not distinct, the bundling is correct and the line is a write off. Do not bill the patient for a bundled line.
References
General information for billing teams, not legal or payer specific advice. CARC definitions belong to X12; payer policies vary and control. Verify against the payer contract before acting on any individual claim.