How do I resolve a CO-252+N434 denial?

Gather the complete medical/clinical record for the dates of service in question. Review the record to confirm it is complete and legible — redact only what is legally required (typically not permitted for insurance purposes). Submit the record via the payer's preferred method (electronic portal, fax, or mail) with the claim number and patient information on every page. Keep a copy of all submitted documentation with proof of delivery (fax confirmation, portal submission number). Follow up 15-20 business days after submission to confirm the payer received the records and claim adjudication has been initiated.

Can I appeal a CO-252+N434 denial?

Yes. CO-252+N434 denials are typically appealable with a 85% success rate. Resolution difficulty is Easy and typically takes 10-21 days.

835 Denial Combination

CO-252+N434

Contractual Obligation · Claim-Level Adjustment

What This Combination Means

Required attachment missing — specifically clinical records or chart notes (N434). The payer cannot adjudicate the claim without the medical record. This is common for complex procedures, hospital admissions, and services subject to retrospective review.

85%

Appeal Success

10-21 days

Avg. Resolution

Easy

Difficulty

Yes

Appealable

Step-by-Step Resolution

Steps tailored specifically to this CO-252+N434 combination — not generic advice.

1
Gather the complete medical/clinical record for the dates of service in question.
2
Review the record to confirm it is complete and legible — redact only what is legally required (typically not permitted for insurance purposes).
3
Submit the record via the payer's preferred method (electronic portal, fax, or mail) with the claim number and patient information on every page.
4
Keep a copy of all submitted documentation with proof of delivery (fax confirmation, portal submission number).
5
Follow up 15-20 business days after submission to confirm the payer received the records and claim adjudication has been initiated.

Specialty Context

How CO-252+N434 typically presents across different practice types.

Dental

Clinical records for periodontal procedures should include probing depths, bleeding on probing, bone loss documentation, and the treatment plan narrative.

Medical

Hospital and surgery claims frequently trigger records requests. The record must include H&P, operative report, anesthesia record, and discharge summary as applicable.

Behavioral Health

For inpatient or residential behavioral health claims, the payer will request the admission assessment, treatment plan, and daily progress notes covering the service period.

Individual Code References

View the standalone definition for each code in this combination.

CARC 252 RARC N434

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