Medical Billing Forum
Billing => Billing => : TXBiller February 22, 2019, 05:33:06 PM
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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.
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Does anyone know?
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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.
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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.
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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
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What software are you using? And what clearinghouse do you use? Does the insurance carrier accept electronic records?
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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
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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.
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You really should know first if you SHOULD or need to send medical record.
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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
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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.
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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?