Denial code · Contractual Obligation (CO)
CO-226 denial code
The payer asked for more facts and did not get them, or got too little.
What the code means
Official meaning: Information requested from the Billing/Rendering Provider was not provided or not provided timely or was insufficient/incomplete. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.)
In plain words: The payer asked for more facts and did not get them, or got too little.
The usual fix
Read the note codes to see what the payer asked for, send the full facts they asked for, and ask the payer to look again.
This is general information, not advice on a specific claim.
Learn on the job
Learn on the job with real denied claims.
Working denied claims is the medical claims desk's daily work. Read a code, find what is missing, fix the claim, or write the appeal.