How do I resolve a CO-252 denial?

Identify the specific documentation type requested by the payer Collect required documents: X-rays, narratives, medical records, lab results See full resolution steps at tryarceum.com.

Can I appeal a CO-252 denial?

CO-252 denials are generally not appealable. This is a request for information rather than a denial, so the appropriate response is to submit the requested documentation rather than file an appeal.

CARC Code

252

🟡 Soft Denial

Additional Documentation Required

The payer needs you to send additional paperwork or supporting documents before they can finish processing your claim. They should have included a remark code telling you exactly what they need.

missing info

Resolution: 85%Easy difficulty7-14 days avg

How to resolve this denial

Which payer denied this claim?

Submit required documentation with claim

1
Identify the specific documentation type requested by the payer
2
Collect required documents: X-rays, narratives, medical records, lab results
3
Attach documentation to the claim using payer's preferred method (electronic PWK, mail, or portal)
4
Resubmit the claim with documentation within the timely filing window
5
Build documentation submission into your standard workflow for these procedures going forward

Resolve this denial →

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

Review the full remittance advice (ERA/EOB) for additional RARC codes that explain the denial.
Verify the claim was submitted with correct patient eligibility and benefit information.
Check if this denial applies to a specific line item or the entire claim.

▶More about CO-252 — stats, related codes, appeal template

85%

Recovery Rate

7-14 days

Avg. Resolution

Easy

Difficulty

Occasional

Frequency

Payer-Specific Notes

How major payers handle CARC 252 by specialty.

Medicare

Prior authorization denials require appeal with clinical records and physician statement

Aetna

Specialty drug claims require pharmacy benefit documentation and clinical protocol adherence

Common 835 Combinations

CARC 252 most often appears with these Group Code + RARC combinations on 835 remittances.

COCO-252+N433The claim was denied because the provider submitted using a non-NPI identifier COCO-252+N434The claim was denied because the Present on Admission (POA) indicator required COCO-252+N275The payer denied this claim because the purchased service provider identifierAppealable COCO-252+N436This combination appears on workers' compensation or injury-related claimsAppealable COCO-252+N437The payer cannot process this claim without additional documentation, but is COCO-252+N356This combination indicates the payer requires additional documentation to COCO-252+N524The payer is stating that additional documentation was required to fully COCO-252+N270The claim cannot be processed because the primary identifier for another

Look up any combination →

Appeal Letter Template

Generic appeal template for CARC 252 denials.

We are submitting the required documentation for claim [CLAIM_NUMBER] (CPT: [CODE], DOS: [DOS]). Attached please find [DOCUMENT_TYPES] as requested. All documentation has been prepared and reviewed for completeness prior to submission.

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