What CO-236 means
This procedure or procedure-modifier combination isn't payable with another one billed on the same day under NCCI or state rules.
The CO group code means this amount is a contractual obligation: under most contracts you cannot bill it to the patient.
Common causes
- NCCI edit hit without an appropriate modifier
How to fix it
- Check the NCCI edit and modifier indicator
- Add a modifier only if the services were distinct and documented
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.