How do I resolve a CO-228 denial?

Review the RARC code to identify the specific document(s) required Gather the required documentation from the provider or medical records department See full resolution steps at tryarceum.com.

Can I appeal a CO-228 denial?

Yes. Most CO-228 denials can be appealed within 60-180 days depending on payer. This is appealable if the requested information was actually provided to the previous payer or if the information request was not properly communicated to the responsible party. Use our free tool to generate an appeal letter.

CARC Code

228

🔴 Hard Denial

Missing Information for Previous Payer

The claim was denied because someone (the provider, another provider, or the patient) did not send information that a previous insurance company requested to process their part of the claim. This typically happens in coordination of benefits situations where secondary or tertiary payers need the primary payer's decision.

missing info

Resolution: 35%Hard difficulty21-45 days avg

How to resolve this denial

Which payer denied this claim?

Submit pre-operative H&P documentation with appeal request

1
Review the RARC code to identify the specific document(s) required
2
Gather the required documentation from the provider or medical records department
3
Submit the documentation through the payer's electronic attachment portal or fax
4
Resubmit the claim with the attachment reference number if required
5
Confirm receipt and track to adjudication

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-228 — stats, related codes, appeal template

35%

Recovery Rate

21-45 days

Avg. Resolution

Hard

Difficulty

Rare

Frequency

Payer-Specific Notes

How major payers handle CARC 228 by specialty.

Blue Cross Blue Shield

BCBS requires appeal submission within 180 days for most plans.

Appeal Letter Template

Generic appeal template for CARC 228 denials.

We are submitting a formal appeal for claim [CLAIM_NUMBER] for patient [PATIENT_NAME], date of service [DOS]. This claim was denied/adjusted with CARC 228 indicating: "Denied for failure to provide pre-operative history and physical.." We have reviewed the claim and are providing the attached documentation to support reconsideration. [SUPPORTING_DOCUMENTATION]. Please reconsider payment per the terms of our contract.

Generate a personalized appeal letter →

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