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CO-26 - Denial Journal
CARC CO — Contractual Obligation

CO-26

Expenses incurred prior to coverage

What This Code Means

The date of service falls before the patient’s coverage effective date with this plan.

Common Causes

  • Claim submitted using wrong effective date
  • Patient enrolled but plan not yet active on service date
  • Retroactive termination or enrollment change

How to Resolve or Appeal

  1. Verify the coverage effective date directly with the payer
  2. Confirm date of service was entered correctly on the claim
  3. If coverage was retroactively backdated, request the payer reprocess
  4. Bill the patient's prior payer if coverage had not yet started

Related Codes

CO-27 CO-31

More Denial Codes to Check

CARC B9 Patient is enrolled in a Hospice CARC CO-32 Records indicate the patient is not an eligible dependent CARC CO-227 RARC MA60 CARC CO-140 CARC CO-178 RARC N30 Patient ineligible for this service CARC CO-100 RARC M138 RARC N52 CARC CO-27 Expenses incurred after coverage terminated

Educational reference only — not medical or legal advice. Always confirm code usage and appeal rights with the specific payer.

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