How do I resolve a CO-236+N184 denial?

Obtain the specific NCCI edit pair reference or the payer's code-editing software report. Evaluate the clinical scenario: were these services truly performed separately and documented as such? If separate: apply the appropriate modifier (59, XS, XE) with supporting clinical documentation showing the distinct services. If bundled correctly: write off the component code and note it in your claim workflow to prevent future submission. Consider requesting the payer's code-editing software rules for the specific CPT combination to understand future prevention.

Can I appeal a CO-236+N184 denial?

Yes. CO-236+N184 denials are typically appealable with a 38% success rate. Resolution difficulty is Medium and typically takes 14-21 days.

835 Denial Combination

CO-236+N184

Contractual Obligation · Service-Line Level Adjustment

What This Combination Means

Mutually exclusive or rebundled combination — N184 confirms the service was rebundled per NCCI or payer code-editing software. The two billed procedures are considered clinically incompatible or redundant when performed together, per established coding guidelines.

38%

Appeal Success

14-21 days

Avg. Resolution

Medium

Difficulty

Yes

Appealable

Step-by-Step Resolution

Steps tailored specifically to this CO-236+N184 combination — not generic advice.

1
Obtain the specific NCCI edit pair reference or the payer's code-editing software report.
2
Evaluate the clinical scenario: were these services truly performed separately and documented as such?
3
If separate: apply the appropriate modifier (59, XS, XE) with supporting clinical documentation showing the distinct services.
4
If bundled correctly: write off the component code and note it in your claim workflow to prevent future submission.
5
Consider requesting the payer's code-editing software rules for the specific CPT combination to understand future prevention.

Specialty Context

How CO-236+N184 typically presents across different practice types.

Dental

Common in dental when prophylaxis and scaling in one visit trigger a mutually exclusive edit under medical necessity review.

Medical

ClaimCheck or Optum editing software is often the source of N184 remarks. The specific software used by the payer determines which code pairs are flagged.

Behavioral Health

Most commonly seen when individual and group therapy are billed on the same day by the same provider.

Individual Code References

View the standalone definition for each code in this combination.

CARC 236 RARC N184

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