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Claim adjustment reason code

CO-227: Requested information from the patient not supplied

CO-227 means: Information requested from the patient/insured/responsible party was not provided or was insufficient/incomplete. 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.) The payer asked the patient for something — very often about other insurance or an accident — and did not get it.

Read the group code before you act on this

227 is the claim adjustment reason code. The CO in front of it is the group code — a separate field the payer sets on the remittance. The same reason code arrives under different group codes depending on the payer and the situation, and the group code, not the reason code, decides who owes the money.

CO — contractual obligation. You write it off. You may not bill the patient.
PR — patient responsibility. Billable to the patient.
OA — other adjustment, and PI — payer initiated reduction. Neither is patient responsibility.

What causes it

Coordination of benefits questionnaire sent to the patient and not returned
Accident or injury details requested and not supplied
Student or dependent status verification outstanding
Payer wrote to an old address

How to work it

Ring the payer and find out exactly what was asked of the patient and how they can supply it.
Contact the patient and tell them specifically what to do — most of these sit unanswered because the payer’s letter was not understood.
Many payers will accept the information over the phone from the patient, which is far faster than post.
Resubmit or ask for reprocessing once the payer confirms it has what it needs.

How to stop it recurring

Ask about other coverage and about accident-related care at registration. A coordination of benefits question answered on day one never becomes this denial.

Who does this work

A patient billing & statements seat at $1,600 per seat per month works this queue full time, during your business hours, inside your own system. Every call is logged with the payer reference number and the outcome, and every Friday you get it in writing.

What that seat does →

Codes worked the same way

CO-227 is answered with the document the payer names. So are these, which is why a queue sorted by recovery route moves faster than one sorted by code number — the same person, in the same system, with the same evidence to hand, clears all of them in one pass.

CO-252 — Additional documentation required
CO-198 — Authorization limit exceeded
CO-226 — Requested information not supplied
CO-251 — Documentation incomplete
N29 — Documentation missing

Specialties that name this among their costliest

These are specialties whose own worst denials include one of this kind. The line under each is the denial they name, quoted from their page so you can see what the link is based on.

Anesthesia
Time units miscalculated from an incomplete anesthesia record
Ophthalmology
Intravitreal injection paid for the administration but not the drug, because the units given and the amount discarded were never written into the note.
Otolaryngology
Endoscopic sinus surgery denied because the chart never pulls the failed medical management together — the drug trials, their dates and imaging findings sit in separate notes or nowhere.
Neurology
Nerve conduction study with needle EMG denied because the report gives only a summary impression instead of each nerve and muscle tested with its findings
Obstetrics & Gynecology
Global maternity package billed in full after the patient transferred care mid-pregnancy, when only the antepartum visits actually rendered here should have been itemised.
Urgent Care
Laceration repair paid at the simplest level because the note says the wound was closed but never records its length, its site or whether the closure was layered

What leaving it costs

Working a denied claim costs $57.23 per denied claim in administrative time. Source. At 100 denials a month — an illustration, not a measurement of your practice — that is $5,723 a month, or $68,676 a year, in labour alone.

The figure that makes it worth spending: about 90% of initially denied claims are eventually paid. Source. The reason a denial sits is almost never that nobody knows how to work it — it is that nobody has the hours.

Questions

What does denial code CO-227 mean?

Information requested from the patient/insured/responsible party was not provided or was insufficient/incomplete. 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.) In plain terms: The payer asked the patient for something — very often about other insurance or an accident — and did not get it.

What causes CO-227?

Coordination of benefits questionnaire sent to the patient and not returned. Accident or injury details requested and not supplied. Student or dependent status verification outstanding. Payer wrote to an old address.

How do you fix a CO-227 denial?

Ring the payer and find out exactly what was asked of the patient and how they can supply it.. Contact the patient and tell them specifically what to do — most of these sit unanswered because the payer’s letter was not understood.. Many payers will accept the information over the phone from the patient, which is far faster than post.. Resubmit or ask for reprocessing once the payer confirms it has what it needs..

Can CO-227 be prevented?

Ask about other coverage and about accident-related care at registration. A coordination of benefits question answered on day one never becomes this denial.

Is CO-227 the same as PR-227?

Same reason, different group code. The number 227 is the reason: The payer asked the patient for something — very often about other insurance or an accident — and did not get it. The prefix says who carries the amount. CO means contractual obligation — the payer says the amount is not billable to anybody, and it is written off unless the denial itself is overturned. PR-227 is the same reason assigned to patient responsibility — the payer says the amount is owed by the patient, and it is billed to them. Read the prefix before the number: it decides whether you appeal, write off, or bill the patient.

What is the difference between CO-227 and CO-226?

CO-227: The payer asked the patient for something — very often about other insurance or an accident — and did not get it. CO-226: The payer asked you for something, and either nothing arrived or what arrived did not answer the question. They are different reasons that happen to sit next to each other in the list, and they are worked differently — CO-227 is answered with the document the payer names; CO-226 is answered with the document the payer names.

Code descriptions are the standard X12 claim adjustment reason and remittance advice remark code text. Payer policies differ, and the payer’s own coverage policy governs any individual claim. This page is working guidance, not legal or clinical advice.

Last updated 2026-09-12. This is operational guidance drawn from payer remittance practice, not legal, coding or reimbursement advice. Payer-specific rules vary and change; confirm against the payer’s own policy before acting on a specific claim.

Written by Ibtesam Asif · Last reviewed 2026-09-12

Code descriptions are the standard published text. Everything after them is operational guidance from our own work, and payer policy governs any individual claim.

Other denial codes

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