CO-167 — Diagnosis Not Covered

CO-167 means the diagnosis is not covered under the plan. In behavioral health, this often surfaces as an exclusion for specific mental health diagnoses (e.g. adjustment disorder, V-codes, SUD) that would not be excluded if they were medical diagnoses. Selectively excluding behavioral health diagnoses is an NQTL under MHPAEA — demand the CAA 2021 § 203 comparative analysis.