835 Denial Combination

CO-163

CO

Contractual Obligation · Claim-Level Adjustment

What This Combination Means

A required attachment was not received by the payer. The claim requires supporting documentation to be processed, and the attachment was either not submitted or was not received. This is correctable by resubmitting the attachment.

88%

Appeal Success

7-14 days

Avg. Resolution

Easy

Difficulty

Yes

Appealable

Step-by-Step Resolution

Steps tailored specifically to this CO-163 combination — not generic advice.

  1. 1

    Identify the specific attachment the payer requires by reviewing the denial notice or calling provider services.

  2. 2

    Gather the requested documentation from your records.

  3. 3

    Submit via the payer's preferred attachment method (electronic portal, NEA FastAttach, or fax).

  4. 4

    Confirm the attachment is clearly labeled with patient name, claim number, and date of service.

  5. 5

    Follow up 10-15 business days after submission to confirm receipt and initiate re-adjudication.

Specialty Context

How CO-163 typically presents across different practice types.

Dental

Dental plans commonly require X-rays for restorations, periodontal treatment notes, and narratives for high-value procedures.

Medical

Surgical claims require operative reports, anesthesia records, and pathology reports as applicable. Post-acute care claims require discharge summaries.

Behavioral Health

Payers may require initial assessments, treatment plans, and progress notes for retrospective review of behavioral health claims.

Individual Code References

View the standalone definition for each code in this combination.

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