CO-2288% overturn rate
This care may be covered by another payer per coordination of benefits
Payer believes patient has primary coverage with another insurer (COB mismatch).
Is this code appealable?
Yes, Highly Appealable
Appealable with COB verification letter or primary payer remittance advice (835).
Plain Language Meaning
What CO-22 actually means
The insurance company thinks another insurance plan should pay first and refuses to pay until you prove otherwise.
Upstream Prevention Strategy:
Automated 270/271 real-time eligibility checks identifying secondary coordination flags prior to billing.
Underlying Root Causes
Why payers issue CO-22
01. Patient demographic update not registered in payer COB master file
02. Commercial plan contesting primary status vs Medicare/Medicaid
03. Accident / workers comp questionnaire not returned by patient
Clinical Dispute Strategy
How to appeal CO-22 and win
Submit primary payer EOB or verified patient COB attestation confirming secondary liability.
Mandatory Attachment Checklist
- •Primary payer EOB
- •Signed patient COB questionnaire
Common Mistakes That Cause Upholds
- •Resubmitting to the same payer without attaching the primary EOB
Zero Long-Term Contracts · Instant 835 Ingest
RecoupOps drafts appeals for CO-22 automatically.
Connect one month of remittances to generate complete clinical packages with LCD citations in 15 seconds.
HIPAA BAA on Every Plan Live in Under 48 Hours 14-Day Full Production Sandbox