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A CO 252 denial code identifies that the insurance company requires additional documentation, such as test results or medical records, to adjudicate the claim. For the unversed, CO stands for contractual obligation, and denial codes with the Group Code CO attached to them are most common in the healthcare industry.
What is an adjustment on EOB?
the difference or discount between what the facility or provider charged and what your insurance paid. (This may also be referred to as an Adjustment, Contracted Agreement, or Allowed Amount.)
What is CO 242 denial code?
Denial code 242 means services were not provided by network or primary care providers.
What is insurance code CO252?
When faced with a CO 22 denial code, healthcare providers have a few options. They can either appeal the denial, provide additional documentation to support the medical necessity of the service, or explore alternative payment options with the patient.
What is denial code co 236?
DESCRIPTION. CO -236. This procedure or procedure/modifier combination is not compatible with another procedure or procedure/modifier combination provided on the same day ing to the National Correct Coding Initiative or workers compensation state regulations/ fee schedule requirements.
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What does CO 252 denial code mean?
Denial code 252 is used when an attachment or other documentation is required in order to process and approve a claim or service.
Related links
Claim Adjustment Reason Codes (CARC) - CT.gov
CARC CODE DESCRIPTION. 1. Deductible Amount. 2. Coinsurance Amount. 3. Co-payment Amount. 4. The procedure code is inconsistent with the modifier used.
Aug 9, 2018 Reason Code 11 A claim was paid under one rate code and then determined it should have been another rate code adjust the paid claim. payment
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