What does CO-297 mean?

CO-297 is a Contractual Obligation (CO) denial: "Claim received by the medical plan, but benefits not available under this plan. Submit these services to the patient's vision plan for further consideration." The medical plan received the claim but these are vision-benefit services, so they belong to the patient's separate vision plan. The fix is to refile to the vision plan, not to appeal the medical plan.

CO · Contractual ObligationCARC 297

Denial Code CO-297

Q: Is CO-297 the patient's responsibility or a provider write-off?

CO-297 carries the CO group code (Contractual Obligation): Provider/contractual responsibility — not billable to the patient while denied. A CO adjustment is the provider's responsibility, not the patient's: balance-billing the patient for a CO amount is a contract (and often compliance) violation. But CO does not automatically mean “write it off.” When the cause is fixable — missing information (CO-16), a modifier problem (CO-4), or NCCI bundling (CO-97) — you correct and resubmit, or appeal with documentation. You only truly write the amount off when it is a final contractual adjustment, such as the fee-schedule difference on CO-45.

Claim received by the medical plan, but benefits not available under this plan. Submit these services to the patient's vision plan for further consideration.

Source: X12 Claim Adjustment Reason Codes (CARC) & Group Codes. Maintained by the D3rx Clinical Billing Team.

What CO-297 means

The medical plan received the claim but these are vision-benefit services, so they belong to the patient's separate vision plan. The fix is to refile to the vision plan, not to appeal the medical plan.

Why CO-297 happens

Routine eye exams, refraction, or eyewear billed to the medical plan
Vision benefits carved out to a separate vision plan/administrator
A service covered under the vision benefit but not the medical benefit
Eligibility shows the patient carries a distinct vision plan

What to do when you get CO-297

1Confirm the service is a vision benefit rather than a medical one
2Identify the patient's vision plan/administrator
3Refile the claim to the vision plan for consideration
4Update the patient's insurance record so vision services route correctly going forward

Got this denial right now?

Fix & resubmit: see the CO-297 correction steps

See CO-297 correction steps Ask D3 about CO-297

CO-297 clears with a corrected claim, not an appeal. Ask D3 walks you through the exact fix — free, no signup.

CO group code: who absorbs the charge

Contractual Obligation — Provider/contractual responsibility — not billable to the patient while denied.

A CO adjustment is the provider's responsibility, not the patient's: balance-billing the patient for a CO amount is a contract (and often compliance) violation. But CO does not automatically mean “write it off.” When the cause is fixable — missing information (CO-16), a modifier problem (CO-4), or NCCI bundling (CO-97) — you correct and resubmit, or appeal with documentation. You only truly write the amount off when it is a final contractual adjustment, such as the fee-schedule difference on CO-45.

Appeal, correct, or write off CO-297?

CO-297 is a 'wrong door' routing denial: the cure is to submit to the patient's vision plan, not to appeal the medical plan. Appealing the medical plan wastes the timely-filing clock. If the service is genuinely a MEDICAL eye condition (not routine vision), confirm coverage and resubmit to the medical plan with the supporting diagnosis instead.

Timing & deadlines

Refile to the vision plan within that plan's timely-filing limit (commonly ~90-180 days; verify with the vision administrator). Because the medical-plan detour consumes time, refile promptly on receipt of CO-297.

Example

A routine refraction is billed to the patient's medical plan, which returns CO-297 and points to the vision plan. Refiling the refraction to the patient's vision carrier resolves it.

Prevent CO-297 going forward

Distinguish routine vision services from medical eye care at scheduling
Capture the patient's vision plan separately from the medical plan
Route refraction/eyewear to the vision benefit by default
Use a medical diagnosis only when the eye care is genuinely medical

Code families most affected

Routine eye exams and refraction (92002-92014, 92015)
92002 92014 92015
Eyewear and contact-lens services
Vision-benefit carve-out services

Related codes

Denial codes you'll often see alongside CO-297

CO-109 CO-16 PR-204

Payer notes

CO-297 specifically routes to the VISION plan; analogous CARCs route to dental or behavioral-health carve-outs. There is nothing to fix on the claim's coding — it simply needs to reach the correct benefit administrator.

Fix this CO-297 denial the right way

CO-297 is resolved with a corrected claim, not an appeal. Ask D3 gives you the exact correction steps — free, backed by CMS, Medicare, and major-payer data.

See CO-297 correction steps Ask D3 about CO-297 All denial codes

Medical billing disclaimer

CARC/RARC definitions are the standardized X12 set; group-code semantics follow the X12 Claim Adjustment Group Code standard. Filing and appeal windows vary by payer — the standard anchors shown (Medicare redetermination 120 days from the remittance; Medicare timely filing 12 months from date of service; most commercial payers ~90-180 days) are general references, not a guarantee for any specific plan. Always confirm the rule in the payer's provider manual before acting. D3rx is not responsible for claim outcomes.