DENIAL CODE · CO-27

CO-27: Coverage Terminated

CO-27 means the payer says the patient's coverage had ended before the date of service. Often it's a data or timing problem, not a true gap.

Official (X12/WPC): "Expenses incurred after coverage terminated."
Written forBilling LeadPractice Manager

Why payers issue CO-27

  • An old or wrong plan was on file at check-in
  • Eligibility changed retroactively after the visit
  • The member ID or date of birth didn't match records
  • The patient had different coverage that day

Is it recoverable? Recoverable by verifying eligibility for the exact date of service, showing reinstatement, or billing the correct payer.

Common questions

What does CO-27 mean?

CO-27 means the payer says the patient's coverage had ended before the date of service. Often it's a data or timing problem, not a true gap. Expenses incurred after coverage terminated.

How do I appeal or fix a CO-27 denial?

Recoverable by verifying eligibility for the exact date of service, showing reinstatement, or billing the correct payer. Common causes: an old or wrong plan was on file at check-in; eligibility changed retroactively after the visit; the member ID or date of birth didn't match records; the patient had different coverage that day.

Is a CO-27 denial worth appealing?

Recoverable by verifying eligibility for the exact date of service, showing reinstatement, or billing the correct payer. You only pay on what's actually recovered, so there's no cost to working the ones that are winnable.

Other denial codes
CO-197 · Precertification / Authorization Absent →CO-50 · Not Medically Necessary →CO-16 · Missing or Invalid Information →CO-45 · Charge Exceeds Fee Schedule →CO-97 · Bundled into Another Service →CO-29 · Timely Filing Expired →CO-96 · Non-Covered Charge →OA-18 · Duplicate Claim →OA-22 · Coordination of Benefits →CO-11 · Diagnosis Inconsistent with Procedure →CO-151 · Too Many Services (Frequency/MUE) →CO-B7 · Provider Not Eligible →CO-204 · Not Covered Under Current Plan →CO-109 · Not Covered by This Payer →CO-119 · Benefit Maximum Reached →CO-4 · Modifier Inconsistent or Missing →CO-15 · Authorization Number Missing or Invalid →OA-23 · Prior Payer Adjudication Impact →CO-24 · Charges Covered Under Capitation →CO-26 · Expenses Incurred Prior to Coverage →CO-54 · Assistant Surgeon Not Covered →CO-55 · Experimental / Investigational →CO-58 · Inappropriate Place of Service →CO-59 · Multiple/Concurrent Procedure Reduction →CO-107 · Related/Qualifying Claim Not Identified →CO-167 · Diagnosis Not Covered →CO-170 · Denied for This Provider Type →CO-181 · Procedure Code Invalid on Date of Service →CO-182 · Procedure Modifier Invalid on Date of Service →CO-183 · Referring Provider Not Eligible to Refer →CO-185 · Rendering Provider Not Eligible →CO-198 · Precertification / Authorization Exceeded →CO-226 · Requested Provider Information Not Provided →CO-231 · Mutually Exclusive Procedures →CO-234 · Procedure Not Paid Separately →CO-236 · Procedure/Modifier Combination Not Compatible →CO-242 · Out-of-Network / Non-Network Provider →CO-252 · Documentation Required to Adjudicate →CO-253 · Sequestration Reduction →CO-256 · Not Payable Per Managed-Care Contract →CO-288 · Referral Absent →CO-B15 · Qualifying Service Not Received →CO-B16 · New Patient Qualifications Not Met →CO-A1 · Claim/Service Denied (Remark Required) →

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