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222
CO - Contractual ObligationCoverage
Denial Code CO-222: Exceeds Contracted Maximum
What Does Code 222 Mean?
Payment adjusted because the service or supply provided exceeds the contracted maximum for this period.
Group Code CO (Contractual Obligation): The provider has agreed to accept the payer's determination. The patient is generally not responsible for this amount.
Why Does This Happen?
The total services or supplies exceed what the contract allows for the time period.
How to Resolve It
- 1Verify the contractual maximum with the payer
- 2Request an exception if additional services are medically necessary
- 3Track usage to prevent exceeding limits
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