What CO-227 means
The payer asked the patient for information, such as other coverage or accident details, and didn't get it.
The CO group code means this amount is a contractual obligation: under most contracts you cannot bill it to the patient.
Common causes
- Patient did not respond to the payer's questionnaire
How to fix it
- Ask the patient to contact their plan
- Resubmit once the plan's records are updated
Check the remark code (RARC) that came with the denial and the payer's own policy, since rules vary by payer and plan. This is a plain-English summary written by GetMax; the official code text is published by X12 at x12.org/codes.
Prevent it next time
Most denials are caused before the claim is sent. See 12 ways to reduce claim denials, or let our denial management team work them for you.