CO 252 Denial Code

A documentation/an attachment is essential to decide this claim/service.

When encountering a CO 252 denial code from an insurance company, it signifies that the claim has been denied due to missing documentation or information required for the processing and reimbursement of the claimed service. However, the CO 252 denial code alone does not provide specific details on what documentation or information is lacking to process the claim.

To obtain a more precise understanding of the denial reason, it is crucial to consult the RARC (Remittance Advice Remark Code) associated with the CO 252 Denial Code. The RARC provides supplementary information that can offer insights into the specific documentation or information that is needed to adjudicate the claim successfully.

By examining the RARC alongside the CO 252 Denial Code, healthcare providers can gain clarity on the exact documentation requirements or information that need to be provided to the insurance company for the claim to be processed and potentially approved for reimbursement.

Following RARC Codes with descriptions are the one, which is attached with the CO 252 Denial Code:

• M23 – Missing invoice
• M127 – Missing patient medical records for this service
• N26 – Missing itemized bill or statement
• N28 – Consent form required is not fulfilled
• N706 – Missing documentation

M23 – Missing invoice

When a claim is denied with CO 252 Denial Code and RARC code M23, it signifies that the claim or service has been rejected due to the absence of an essential invoice needed for claim processing. To rectify this issue and ensure the claim is processed successfully, it is imperative to submit the missing invoice along with the claim. By including the necessary documentation, the claim can move forward in the processing pipeline towards reimbursement.

Therefore, it is crucial for healthcare providers to pay close attention to such denials, promptly address the missing invoice requirement, and resubmit the claim to facilitate proper adjudication. Failure to comply with this request could result in further delays in claim processing and potential revenue loss. Adhering to proper documentation requirements and promptly addressing denial codes such as CO 252 with RARC code M23 is essential for maintaining a streamlined revenue cycle and ensuring timely reimbursement for services rendered

M127 – Missing patient medical records for this claim or service

The M127 RARC code, when attached with the CO 252 Denial Code, signifies that the claim submitted to insurance did not include the patient’s essential medical records necessary for adjudication. In such instances, it is imperative to resubmit the claim along with the requested medical records to enable the thorough evaluation and processing of the claim or service.

N26 – Missing Itemized bill or statement

CO 252 denial code with N26 RARC code typically indicates that the claim was denied because it was submitted without an itemized bill or statement. In order to address this denial and have the claim reconsidered, it is crucial to provide a detailed itemized bill or statement that accurately documents the services provided.

When submitting a claim to insurance companies, it is essential to include an itemized bill that clearly outlines the various services rendered, their corresponding charges, and any applicable codes or descriptions.

N28 – Consent form required is not fulfilled

When a claim is denied with CO 252 Denial Code and N28 RARC code, it signifies that the submitted claim did not include the essential consent forms specified by the payer’s regulations. This rejection is commonly encountered when crucial documentation such as the final evaluation form for a wheelchair, sterilization consent form, abortion consent form, or hospital surgical consent form is missing.

Healthcare providers must ensure that all required consent forms are completed and submitted along with the claim to prevent such denials. The absence of these forms can lead to claim rejections and delays in payment processing. By incorporating a comprehensive and systematic approach to document collection and submission, providers can mitigate the risk of encountering CO 252 Denial Code with N28 RARC code.

N706 – Missing documentation

When receiving a denial with CO 252 and N706 RARC codes due to incomplete patient records, it signifies that the claim submitted lacks essential information such as missing test results, operative notes, discharge summaries, or crucial diagnosis/procedure/modifier details. This denial necessitates a manual review and prompts the need to resubmit the claim with the missing information attached.

How to handle Denial code CO 252

• When encountering denial code CO 252, the initial course of action is to diligently review the application to ascertain if the requested information has indeed been submitted. If the information has been provided, it is imperative to promptly initiate follow-up procedures to address the denied claim
• However, if the requested information is missing, it is essential to refer to the attached RARC code to identify the specific reason for denial. Subsequently, the next course of action involves submitting the required information promptly to facilitate the processing of the claim. It is imperative to address denial code CO 252 efficiently by acknowledging the importance of providing complete and accurate information to resolve the issue and expedite the reimbursement process.

Note: It is advisable to contact the claims department to ascertain the exact reason for denial. If there is uncertainty regarding missing information, reaching out to the claims department is crucial to clarify what is needed. By engaging proactively in this process, one can ensure that the necessary information is provided for the claim to be resubmitted for adjudication.