CO-287 denial code: referral amount exceeded

CO-287 fires when the care delivered exceeds what a referral authorized — most often a visit count consumed without anyone tracking it. The extension has to come from the referring physician, not from the specialist appealing.

What CO-287 means

Referrals are granted for a number of visits over a period, and neither practice usually tracks the count against the payer's record. The specialist discovers the exceedance at denial, weeks after the visits happened. Because the referring physician holds the authority to extend, the resolution is a request to them rather than an appeal to the payer — and many plans allow a retroactive extension within a window.

Why CO-287 fires

• The visit count on the referral was consumed by earlier encounters.
• The referral period expired mid-course.
• The referral authorized a lower amount than the care required.
• Earlier claims against the same referral were not visible to the specialist.

Is CO-287 worth appealing?

How to resolve or appeal CO-287

1. 1

   Confirm the referral's terms

   Visit count, period and specialty, from the payer's record rather than the paperwork you were sent.

2. 2

   Request an extension from the referring practice

   That is where the authority sits; the payer will not extend on the specialist's request.

3. 3

   Track the count going forward

   Recording remaining visits at each encounter prevents the next occurrence.

CO-287 — frequently asked

Reason-code meanings are paraphrased from the X12 Claim Adjustment Reason Code list for plain-language reference; they are not reproduced verbatim. This is general information, not legal, coding, or medical advice — always confirm against the payer's remittance and policy.