835 Denial Combination
CO-226+N275
Contractual Obligation · Claim-Level Adjustment
Missing InformationWhat This Combination Means
The claim was denied because the provider identifier for a purchased service from another payer was missing, incomplete, or invalid. This typically occurs in coordination of benefits scenarios where Medicare or another primary payer needs to identify the servicing provider associated with services purchased from an external vendor or subcontractor. The payer is applying a contractual adjustment requiring provider write-off due to incomplete claim submission.
Financial Responsibility
provider writeoff
The provider must write off the denied amount per contractual obligation with the payer. The patient cannot be billed for this adjustment because the denial resulted from the provider's failure to supply complete purchased service provider information.
N/A
Appeal Success
1-2 billing cycles (corrected claim submission)
Avg. Resolution
Medium
Difficulty
No
Appealable
Step-by-Step Resolution
Steps tailored specifically to this CO-226+N275 combination — not generic advice.
- 1
Identify the purchased service arrangement referenced in the claim
Determine which service was subcontracted or purchased from another provider that requires coordination of benefits reporting
- 2
Obtain the complete National Provider Identifier (NPI) or other payer-specific identifier for the purchased service provider
Verify the identifier format matches payer requirements for purchased service reporting in coordination of benefits scenarios
- 3
Submit a corrected claim with the purchased service provider identifier populated in the appropriate Loop 2420E (purchased service information) fields
Include all required elements for the other payer's purchased service provider to enable proper coordination of benefits processing
Specialty Context
How CO-226+N275 typically presents across different practice types.
Dental
May occur when dental management organizations purchase services from independent specialists and coordination of benefits requires identification of the servicing provider for crossover claims
Medical
Common in laboratory, radiology, or anesthesia services purchased from external vendors when Medicare or other primary payer requires the actual performing provider identifier for coordination of benefits
Behavioral Health
Can occur when behavioral health organizations purchase psychiatric or counseling services from contracted individual providers and crossover claims require specific provider identification
Individual Code References
View the standalone definition for each code in this combination.
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