835 Denial Combination

CO-22+MA04

CO

Contractual Obligation · Service-Line Level Adjustment

What This Combination Means

This claim appears to be covered by a primary payer. The primary payer information was either not reported or was illegible on the claim

N/A

Appeal Success

7-14 days

Avg. Resolution

Medium

Difficulty

No

Appealable

Step-by-Step Resolution

Steps tailored specifically to this CO-22+MA04 combination — not generic advice.

  1. 1

    Correct claim with the insurance information and resubmit as a new claim

Specialty Context

How CO-22+MA04 typically presents across different practice types.

Dental

Medical

Behavioral Health

Individual Code References

View the standalone definition for each code in this combination.

Medicare Contractor Guidance for CARC 22

FCSO + Noridian + uhc + aetna + bcbs_az

This care may be covered by another payer per coordination of benefits. This denial was received because Medicare records indicate that Medicare is the secondary payer.

How to Prevent CARC 22 Denials

  • Ask the patient or patient representative to complete the Medicare Secondary Payer (MSP) Questionnaire to help determine if Medicare is the primary or secondary payer. Place the completed questionnaire in the patient's file.

  • Check patient eligibility and verify if Medicare is the secondary payer via SPOT.

CMS IOM Pub. 10-05 Medicare Secondary Payer, Chapter 2SPOTNMP

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