CommonContractual Obligation (CO)Other
CO-252: Service not adjudicated -- additional information requested
The payer is requesting additional information before the claim can be processed. The claim is being held pending receipt of the requested documentation. This is not a final denial but a request for more information.
Common Causes
- Medical records or operative notes required for claim review
- Additional clinical documentation needed to support medical necessity
- Accident or injury details requested
- Workers' compensation or third-party liability questionnaire needed
- Coordination of benefits information required
How to Resolve CO-252
- 1Review the RARC codes to determine exactly what information is requested
- 2Gather the requested documentation from the medical record
- 3Submit the additional information within the payer's specified timeframe
- 4Follow up to confirm receipt and monitor for adjudication
- 5If the request seems unreasonable, contact the payer for clarification
How to Prevent CO-252 Denials
- Submit complete medical records with claims for services that commonly require documentation
- Proactively attach operative notes for surgical claims
- Respond to additional documentation requests within 48 hours
Related Denial Codes
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