How do I resolve a CO-236 denial?

Review NCCI edits for the billed procedure combination Determine if a modifier is applicable to bypass the bundling edit (e.g., -59, XE, XS, XP, XU) See full resolution steps at tryarceum.com.

Can I appeal a CO-236 denial?

Yes. Most CO-236 denials can be appealed within 60-180 days depending on payer. This code is appealable if documentation supports that the procedures were performed in separate anatomical sites, separate sessions, or were otherwise distinct and appropriately reported. Use our free tool to generate an appeal letter.

CARC Code

236

🔴 Hard Denial

Procedure Combination Not Compatible

Two or more procedures billed together on the same day cannot be performed together according to coding rules. The National Correct Coding Initiative (NCCI) or workers compensation regulations prevent these specific procedures from being billed at the same time.

coding

Resolution: 55%Medium difficulty14-30 days avg

How to resolve this denial

Which payer denied this claim?

▶✓ Pre-action checklist — verify before contacting the payer

Is this service explicitly excluded under the patient's benefit plan?
Was an Advance Beneficiary Notice (ABN) or financial responsibility form signed?
Check if a different CPT code would be covered for the same service.

▶More about CO-236 — stats, related codes, appeal template

55%

Recovery Rate

14-30 days

Avg. Resolution

Medium

Difficulty

Common

Frequency

Payer-Specific Notes

How major payers handle CARC 236 by specialty.

Blue Cross Blue Shield

BCBS requires appeal submission within 180 days for most plans.

Common 835 Combinations

CARC 236 most often appears with these Group Code + RARC combinations on 835 remittances.

COCO-236This combination indicates a National Correct Coding Initiative (NCCI) edit COCO-236+N184The claim was denied because procedures billed together on the same date COCO-236+N104This combination indicates the claim was received by the wrong Medicare COCO-236+N610The payer has applied NCCI edits or fee schedule rules to deny one procedure as COCO-236+N519The claim contains procedures billed with an invalid combination of HCPCS

Look up any combination →

Appeal Letter Template

Generic appeal template for CARC 236 denials.

We are submitting a formal appeal for claim [CLAIM_NUMBER] for patient [PATIENT_NAME], date of service [DOS]. This claim was denied/adjusted with CARC 236 indicating: "Procedure or procedure/modifier combination is not compatible with another proce." We have reviewed the claim and are providing the attached documentation to support reconsideration. [SUPPORTING_DOCUMENTATION]. Please reconsider payment per the terms of our contract.

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