skip to content
Thank you for visiting First Coast Service Options' Medicare provider website. This website is intended exclusively for Medicare providers and health care industry professionals to find the latest Medicare news and information affecting the provider community.
To enable us to present you with customized content that focuses on your area of interest, please select your preferences below:
Select which best describes you:
Select your location:
Select your line of business:
This website provides information and news about the Medicare program for health care professionals only. All communication and issues regarding your Medicare benefits are handled directly by Medicare and not through this website. For the most comprehensive experience, we encourage you to visit or call 1-800-MEDICARE. In the event your provider fails to submit your Medicare claim, please view these resources for claim assistance.
Join eNews       En Español
Text Size:
YouTube LinkedIn Email Print
Send a link to this page
[Multiple email adresses must be separated by a semicolon.]
Last Modified: 7/17/2022 Location: FL, PR, USVI Business: Part B

Return unprocessable claim (RUC) reason code CO109 FAQ

Q: We received a RUC for the claim adjustment reason code (CARC) CO109. What steps can we take to avoid this RUC code?
Claim/service not covered by this payer/contractor. You must send the claim/service to the correct payer/contractor.
A: The first step in avoiding the reason code CO109 is to check what type of insurance coverage the patient has and verify their eligibility status prior to submitting claims to Medicare.
If the claim has been filed to Medicare in error it will be returned as an unprocessable claim and will need to be resubmitted to the correct payer/contractor for payment.
In receiving this error, the provider can also refer to their remittance advice (RA) by evaluating the accompanying remittance advice remark code (RARC) to determine the correct payer/contractor of service.
Common reasons:
Railroad Retirement benefits (RRB)
Receiving Part A benefits in a Skilled Nursing Facility on the date of service
Medicare Health Maintenance Organization (HMO)
Durable medical equipment (DME)
Claim(s) submitted to different region (other than beneficiary resides in)
Ways to avoid:
Check beneficiary eligibility prior to submitting claims to Medicare
Click here to obtain options on how to access a beneficiary's eligibility
SPOT will also display an alert on the eligibility screen notifying the beneficiary is a Railroad Retiree
SPOT will only furnish information regarding payments processed by First Coast
Medicare payments for DME or railroad claims will not be displayed
Claims that are returned as unprocessable cannot be appealed, for more information click here
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.