How do I resolve a CO-252+N433 denial?

Identify exactly which X-ray or image the payer is requesting — the denial should specify the procedure code that triggered the attachment requirement. Locate the X-ray or image in your records (PACS system, digital radiography software, or paper films). Confirm the payer's preferred attachment submission method: electronic (NEA FastAttach, Change Healthcare, Tesia) or paper (with the EOB or a cover sheet). Submit the attachment with the payer's claim number, patient name, and date of service clearly labeled. Follow up with the payer 10-15 business days after attachment submission to confirm receipt and trigger adjudication. If the payer requires re-submission rather than an attachment, resubmit the corrected claim with the image attached.

Can I appeal a CO-252+N433 denial?

Yes. CO-252+N433 denials are typically appealable with a 88% success rate. Resolution difficulty is Easy and typically takes 7-14 days.

835 Denial Combination

CO-252+N433

Contractual Obligation · Claim-Level Adjustment

What This Combination Means

Required attachment missing — specifically an X-ray or image (N433) that is necessary for the payer to adjudicate this claim. The service will be denied or held until the requested attachment is received. This is common for dental radiograph requirements and radiology service documentation.

88%

Appeal Success

7-14 days

Avg. Resolution

Easy

Difficulty

Yes

Appealable

Step-by-Step Resolution

Steps tailored specifically to this CO-252+N433 combination — not generic advice.

1
Identify exactly which X-ray or image the payer is requesting — the denial should specify the procedure code that triggered the attachment requirement.
2
Locate the X-ray or image in your records (PACS system, digital radiography software, or paper films).
3
Confirm the payer's preferred attachment submission method: electronic (NEA FastAttach, Change Healthcare, Tesia) or paper (with the EOB or a cover sheet).
4
Submit the attachment with the payer's claim number, patient name, and date of service clearly labeled.
5
Follow up with the payer 10-15 business days after attachment submission to confirm receipt and trigger adjudication.
6
If the payer requires re-submission rather than an attachment, resubmit the corrected claim with the image attached.

Specialty Context

How CO-252+N433 typically presents across different practice types.

Dental

Most dental payers require X-rays for procedures involving restorations, extractions, and periodontal treatment. Submit bitewing and/or periapical X-rays with the claim. Check the payer's attachment format requirements (electronic via Change Healthcare/Tesia, or paper).

Medical

Radiology claims frequently require the original imaging study report or DICOM images. Confirm whether the payer wants the interpretation report, the images themselves, or both.

Behavioral Health

Rare in behavioral health. May appear for neuropsychological testing claims that require supporting imaging (MRI, CT) to justify certain test codes.

Individual Code References

View the standalone definition for each code in this combination.

CARC 252 RARC N433

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