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26
CO - Contractual ObligationCoverage
Denial Code CO-26: Expenses Before Coverage
What Does Code 26 Mean?
Expenses incurred prior to coverage. The date of service is before the patient's coverage effective date.
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?
Patient was not yet enrolled in the plan on the date of service.
How to Resolve It
- 1Verify the patient's coverage effective date
- 2Bill the patient directly if not covered
- 3Check for other insurance that may have been active
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