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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 CO-141 RARC MA96 CARC CO-184 CARC CO-140 CARC CO-27 Expenses incurred after coverage terminated CARC CO-100 CARC CO-239 CARC PR-238 RARC MA90 CARC CO-D23 CARC CO-227 CARC B9 Patient is enrolled in a Hospice

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

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