ModerateContractual Obligation (CO)Coding & Billing

CO-236: Procedure/revenue code not found or invalid

The procedure code or revenue code submitted on the claim is not valid. The code may not exist, may have been deleted from the code set, or may be invalid for the date of service.

Common Causes

  • Typographical error in the CPT/HCPCS code
  • Deleted or expired procedure code used on the claim
  • Revenue code mismatch with the procedure code for facility claims
  • Using a code not yet effective as of the date of service

How to Resolve CO-236

  1. 1Verify the correct CPT/HCPCS code for the service rendered
  2. 2Check that the code was valid/effective on the date of service
  3. 3For facility claims, verify the revenue code matches the procedure
  4. 4Correct the code and resubmit the claim

How to Prevent CO-236 Denials

  • Update code sets annually when new CPT codes are released
  • Use billing software with built-in code validation
  • Cross-reference revenue codes with CPT codes for facility claims

Related Denial Codes

CO-4Very Common

Procedure code inconsistent with modifier or not valid for date of service

CO-16Very Common

Claim/service lacks information needed for adjudication

Stop Denials Before They Happen

Greenlight validates procedure and diagnosis code combinations against payer rules before claims are submitted, catching coding errors before they become denials.

See How It Works