Author Topic: Denial CO-252 (Read 13291 times)

TXBiller · « **on:** February 22, 2019, 05:33:06 PM »

Hi All

Can someone please tell me what the below denial code means and how to resolve it?

CO-252: An attachment/other document is required to adjudicate this claim/service. 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)

Thank you in advance for any assistance you can give me.

TXBiller · « **Reply #1 on:** February 24, 2019, 08:16:53 PM »

Does anyone know?

Michele · « **Reply #2 on:** February 24, 2019, 08:25:05 PM »

That is telling you that another remark code should be on the EOB explaining the denial. If there is no other code then you should call and ask them to explain the denial.

kristin · « **Reply #3 on:** February 27, 2019, 03:55:03 PM »

Every time I have ever seen this denial code (always with BCBS of Illinois) it means they want the treatement note/medical record for the DOS.

TXBiller · « **Reply #4 on:** March 01, 2019, 09:40:43 AM »

Kristin -

I went back and look and that is another code listed. They want the medical record. I'm new to this software so I'm unsure how to get the medical record to them. Do I send it electronically, fax it, etc.? Any suggestions would be greatly appreciate.

Thank you

Medical Billing Forum · « **Reply #4 on:** March 01, 2019, 09:40:43 AM »

Michele · « **Reply #5 on:** March 01, 2019, 10:51:59 AM »

What software are you using? And what clearinghouse do you use? Does the insurance carrier accept electronic records?

TXBiller · « **Reply #6 on:** March 01, 2019, 11:55:09 AM »

We are using Kareo. I’m not sure about the clearinghouse as it’s inside Kareo. The carrier is BCBS.

Is there a list of carriers that accept and don’t accept?

Thank you

Michele · « **Reply #7 on:** March 05, 2019, 09:45:05 AM »

I would check with Kareo to see if you can submit the records electronically. If you can't then I would send it on paper.

PMRNC · « **Reply #8 on:** March 25, 2019, 05:32:40 PM »

You really should know first if you SHOULD or need to send medical record.

TXBiller · « **Reply #9 on:** March 31, 2019, 07:09:23 AM »

How do I know when I SHOULD or need to send the medical record? At this point, I don't know until the claim comes back saying it.

Any advice would be greatly appreciated.

TIA

Medical Billing Forum · « **Reply #9 on:** March 31, 2019, 07:09:23 AM »

Michele · « **Reply #10 on:** April 02, 2019, 10:52:03 AM »

I would only send the medical record if it is requested. That is usually done by either a letter from the carrier or on an EOB.

PMRNC · « **Reply #11 on:** April 03, 2019, 09:39:10 AM »

If it is ERISA you should investigate a bit further, you may not need the medical record.

What were services for? Is this a group health plan under ERISA?

Medical Billing Forum · « **Reply #11 on:** April 03, 2019, 09:39:10 AM »

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