OakClaim
CO-256Contractual ObligationContractual

CO-256 Denial Code: Service not payable per managed care contract

The service is not payable per the managed care contract.

Why CO-256 happens

  • Service carved out or bundled under the managed care agreement

How to fix a CO-256 denial

  1. 1

    Review the contract terms for the service

  2. 2

    Bill the correct carve-out entity, or adjust per contract

How to prevent it

Document carve-outs by payer contract in billing rules.

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