How do I resolve a CO-62+N285 denial?

Retrieve the original authorization/referral documentation: Verify whether a valid authorization exists and identify the complete referring provider information including NPI, name, and credentials as documented at time of authorization request Cross-reference authorization records with payer portal: Confirm the authorization number is valid and determine if the referring provider name on file with the payer matches what was submitted on the claim Submit appeal with corrected referring provider information: Include authorization approval documentation, complete referring provider demographics, and explanation that valid authorization existed but contained incomplete referring provider data element

835 Denial Combination

CO-62+N285

Contractual Obligation · Claim-Level Adjustment

Authorization / Pre-certification

What This Combination Means

This combination indicates the claim was denied or reduced due to missing or invalid authorization, with the specific issue being that the referring provider name on the authorization documentation is missing, incomplete, or invalid. The payer cannot validate the pre-certification or authorization without proper referring provider identification, making the authorization ineffective for claim processing purposes.

Financial Responsibility

provider writeoff

The provider must write off the denied amount per contractual obligations with the payer. The patient cannot be billed for this adjustment.

45%

Appeal Success

30-60 days (appeal process)

Avg. Resolution

Hard

Difficulty

Yes

Appealable

Step-by-Step Resolution

Steps tailored specifically to this CO-62+N285 combination — not generic advice.

Appealable:Authorization denials under CO are appealable when valid authorization exists but administrative data elements like referring provider name are correctable.

1
Retrieve the original authorization/referral documentation
Verify whether a valid authorization exists and identify the complete referring provider information including NPI, name, and credentials as documented at time of authorization request
2
Cross-reference authorization records with payer portal
Confirm the authorization number is valid and determine if the referring provider name on file with the payer matches what was submitted on the claim
3
Submit appeal with corrected referring provider information
Include authorization approval documentation, complete referring provider demographics, and explanation that valid authorization existed but contained incomplete referring provider data element

Specialty Context

How CO-62+N285 typically presents across different practice types.

Dental

Common when specialists require referrals from general dentists; authorization must include complete referring dentist name and NPI for procedures like oral surgery or orthodontics

Medical

Frequent in specialty care requiring referrals (cardiology, orthopedics, pain management) where authorization is tied to specific referring physician; incomplete PCP or referring specialist name invalidates authorization

Behavioral Health

Applies to therapy or psychiatric services requiring PCP or psychiatrist referral; authorization must contain complete referring provider information for outpatient mental health or substance abuse treatment

Individual Code References

View the standalone definition for each code in this combination.

CARC 62 RARC N285

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Synthesized from official definitions — not from training data

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