CO-211Contractual ObligationContractual
CO-211 Denial Code: NDC not eligible for rebate — not covered
Medicaid-flavored denial: the drug's NDC isn't in the federal rebate program, so the program won't cover it.
Why CO-211 happens
- ●Non-rebate-participating manufacturer's NDC dispensed to a Medicaid patient
How to fix a CO-211 denial
- 1
Switch to a rebate-eligible equivalent NDC; rebill with it going forward
How to prevent it
Pharmacy systems should flag non-rebate NDCs for Medicaid patients at dispensing.
Drowning in CO-211 denials?
OakClaim works every denial within 48 hours and builds prevention rules so they stop recurring.