835 Denial Combination

CO-50+M86

CO

Contractual Obligation · Service-Line Level Adjustment

What This Combination Means

Medical necessity denied — service was denied based on the MAC's medical review criteria.

50%

Appeal Success

21-60 days

Avg. Resolution

Hard

Difficulty

Yes

Appealable

Step-by-Step Resolution

Steps tailored specifically to this CO-50+M86 combination — not generic advice.

  1. 1

    Review denial details for CO-50-M86 and identify the specific issue.

  2. 2

    Pull the relevant documentation (records, auth, NPI information) supporting this claim.

  3. 3

    Correct the identified error or gather required documentation.

  4. 4

    Resubmit as a corrected claim or submit an appeal with supporting documentation.

  5. 5

    Follow up with the payer within 10-15 business days to confirm adjudication.

Specialty Context

How CO-50+M86 typically presents across different practice types.

Dental

Apply dental billing best practices for CO-50-M86 denial resolution.

Medical

Apply medical billing guidelines for CO-50-M86 denial — verify payer-specific requirements.

Behavioral Health

Apply behavioral health billing standards for CO-50-M86 — confirm MHPAEA compliance.

Individual Code References

View the standalone definition for each code in this combination.

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