# Claim edit: COB service lines must be balanced

> Stedi now rejects 837P professional, 837D dental, and 837I institutional claims sent to a non-primary payer when a service line's coordination of benefits (COB) amounts don't balance.

Published Apr 9, 2026

Product: Claim edits

Stedi now rejects [837P professional](https://www.stedi.com/docs/healthcare/submit-professional-claims), [837D dental](https://www.stedi.com/docs/healthcare/submit-dental-claims), and [837I institutional](https://www.stedi.com/docs/healthcare/submit-institutional-claims) claims sent to a non-primary payer when a service line's coordination of benefits (COB) amounts don't balance.

## How the edit works

When a patient has multiple insurance plans, the provider submits a claim to each payer in order. The first is the primary payer. Any that follow are secondary, tertiary, and so on. This process is called coordination of benefits (COB).

A service line is a line item for a specific service on a claim, like an office visit or X-ray.

When you submit a claim to a non-primary payer, you must include each previous payer's adjudications – their payments and adjustments. Include both claim-level and service line-level adjudications from each prior payer. Don't include the same amounts at both levels.

### Balancing service lines

When you include prior payer adjudications at the service line level, the amounts must add up as follows:

**Billed line charge**

| **Claim type**                                                                          | **JSON API field**                                                                                                                                                                                                                                   | **X12 element**                                                           |
| --------------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------- |
| [837P professional](https://www.stedi.com/docs/healthcare/submit-professional-claims)   | [`claimInformation.serviceLines[].professionalService.lineItemChargeAmount`](https://www.stedi.com/docs/healthcare/api-reference/post-healthcare-claims#body.claimInformation.serviceLines.professionalService.lineItemChargeAmount)                 | `SV1-02` (Line Item Charge Amount) of Loop `2400` (Professional Service)  |
| [837D dental](https://www.stedi.com/docs/healthcare/submit-dental-claims)               | [`claimInformation.serviceLines[].dentalService.lineItemChargeAmount`](https://www.stedi.com/docs/healthcare/api-reference/post-healthcare-dental-claims#body.claimInformation.serviceLines.dentalService.lineItemChargeAmount)                      | `SV3-02` (Line Item Charge Amount) of Loop `2400` (Dental Service)        |
| [837I institutional](https://www.stedi.com/docs/healthcare/submit-institutional-claims) | [`claimInformation.serviceLines[].institutionalService.lineItemChargeAmount`](https://www.stedi.com/docs/healthcare/api-reference/post-healthcare-institutional-claims#body.claimInformation.serviceLines.institutionalService.lineItemChargeAmount) | `SV2-03` (Line Item Charge Amount) of Loop `2400` (Institutional Service) |

**Prior payer line paid amount**

| **Claim type**                                                                          | **JSON API field**                                                                                                                                                                                                                                                     | **X12 element**                                                                    |
| --------------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------- |
| [837P professional](https://www.stedi.com/docs/healthcare/submit-professional-claims)   | [`claimInformation.serviceLines[].lineAdjudicationInformation[].serviceLinePaidAmount`](https://www.stedi.com/docs/healthcare/api-reference/post-healthcare-claims#body.claimInformation.serviceLines.lineAdjudicationInformation.serviceLinePaidAmount)               | `SVD-02` (Service Line Paid Amount) of Loop `2430` (Line Adjudication Information) |
| [837D dental](https://www.stedi.com/docs/healthcare/submit-dental-claims)               | [`claimInformation.serviceLines[].lineAdjudicationInformation[].serviceLinePaidAmount`](https://www.stedi.com/docs/healthcare/api-reference/post-healthcare-dental-claims#body.claimInformation.serviceLines.lineAdjudicationInformation.serviceLinePaidAmount)        | `SVD-02` (Service Line Paid Amount) of Loop `2430` (Line Adjudication Information) |
| [837I institutional](https://www.stedi.com/docs/healthcare/submit-institutional-claims) | [`claimInformation.serviceLines[].lineAdjudicationInformation[].serviceLinePaidAmount`](https://www.stedi.com/docs/healthcare/api-reference/post-healthcare-institutional-claims#body.claimInformation.serviceLines.lineAdjudicationInformation.serviceLinePaidAmount) | `SVD-02` (Service Line Paid Amount) of Loop `2430` (Line Adjudication Information) |

**Line adjustment amounts**

| **Claim type**                                                                          | **JSON API field**                                                                                                                                                                                                                                                                                                                                  | **X12 element**                                                                                               |
| --------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------- |
| [837P professional](https://www.stedi.com/docs/healthcare/submit-professional-claims)   | [`claimInformation.serviceLines[].lineAdjudicationInformation[].claimAdjustmentInformation[].adjustmentDetails[].adjustmentAmount`](https://www.stedi.com/docs/healthcare/api-reference/post-healthcare-claims#body.claimInformation.serviceLines.lineAdjudicationInformation.claimAdjustmentInformation.adjustmentDetails.adjustmentAmount)        | `CAS-03`, `CAS-06`, `CAS-09`, `CAS-12`, `CAS-15`, and `CAS-18` of Loop `2430` (Line Adjudication Information) |
| [837D dental](https://www.stedi.com/docs/healthcare/submit-dental-claims)               | [`claimInformation.serviceLines[].lineAdjudicationInformation[].claimAdjustmentInformation[].adjustmentDetails[].adjustmentAmount`](https://www.stedi.com/docs/healthcare/api-reference/post-healthcare-dental-claims#body.claimInformation.serviceLines.lineAdjudicationInformation.claimAdjustmentInformation.adjustmentDetails.adjustmentAmount) | `CAS-03`, `CAS-06`, `CAS-09`, `CAS-12`, `CAS-15`, and `CAS-18` of Loop `2430` (Line Adjudication Information) |
| [837I institutional](https://www.stedi.com/docs/healthcare/submit-institutional-claims) | [`claimInformation.serviceLines[].lineAdjudicationInformation[].lineAdjustment[].claimAdjustmentDetails[].adjustmentAmount`](https://www.stedi.com/docs/healthcare/api-reference/post-healthcare-institutional-claims#body.claimInformation.serviceLines.lineAdjudicationInformation.lineAdjustment.claimAdjustmentDetails.adjustmentAmount)        | `CAS-03`, `CAS-06`, `CAS-09`, `CAS-12`, `CAS-15`, and `CAS-18` of Loop `2430` (Line Adjudication Information) |

If the amounts don't balance for any service line adjudication, the payer may reject the claim.

This [edit](https://www.stedi.com/docs/healthcare/claim-edits-and-repairs#edits) catches the issue before the claim reaches the payer. It prevents payer rejections, which are slower and delay payment for the provider.

We previously added a separate edit for [claim-level COB balancing](https://www.stedi.com/changelog/new-claim-edit-cob-claims-must-be-balanced).

## Rejection errors

If you submit a claim using Stedi's [Claim Submission API endpoints](https://www.stedi.com/docs/healthcare/intro-to-claim-submission#api-claim-submission) and the claim fails the edit, you'll get back an error response in real time. The response includes details in the `errors` array.

```jsonc
{
  "errors": [
    {
      "code": "33",
      "description": "Coordination of Benefits (COB) balancing failed. For line 1, the total charged amount of $150.00 does not equal the sum of the paid amount of $0.00 and all adjustment amounts of $200.00 for payer STEDITEST. Correct and resubmit.",
      "followupAction": "Please Correct and Resubmit"
    }
  ]
}
```

If you submit a claim using [SFTP](https://www.stedi.com/docs/healthcare/submit-claims-sftp-connection) and the claim fails the edit, Stedi will reject the claim with a [277CA claim acknowledgment](https://www.stedi.com/docs/healthcare/claim-responses-overview#277ca-claim-acknowledgment). The acknowledgment will include a related [claim status category code](https://x12.org/codes/claim-status-category-codes), [claim status code](https://x12.org/codes/claim-status-codes), and error message.

```jsx
STC*A7>551*[DATE]*U*[AMOUNT]********Coordination of Benefits (COB) balancing failed. For line 1, the total charged amount of $150.00 does not equal the sum of the paid amount of $0.00 and all adjustment amounts of $200.00 for payer STEDITEST. Correct and resubmit.~
```