CO 226: Requested Information Missing
The payer asked you for information and did not get it, or did not get enough.
Find the original request, send exactly what it asked for, and send it in the format they asked for. Most of these are lost letters, not refusals.
See a finished review first
- No patient data
- No BAA
- No charge
- No pitch
What CO 226 means
CO: Contractual obligation. The provider absorbs it and cannot bill the patient.
So the balance cannot move to the patient. Either the appeal recovers it or the practice absorbs it. That makes the appeal decision the whole decision on this line.
Is It Worth Appealing?
Usually recoverable. Appeal it. The money is usually there.
Why It Fires
In the order we see it.
A records request went to an old address or a fax nobody watches.
Records were sent but arrived after the payer's clock ran out.
What was sent did not include the specific item requested.
How to Appeal CO 226, Step by Step
Find the original request, send exactly what it asked for, and send it in the format they asked for. Most of these are lost letters, not refusals.
- 1Step 1: Read the remark code. Find the remark code printed next to CO 226 on the 835 or EOB. It says what the payer wants back. The usual ones are N706.
- 2Step 2: Find the cause. Match the denial to one of the 3 causes in Why It Fires above, and fix that one.
- 3Step 3: Take the first action. Find the original request, send exactly what it asked for, and send it in the format they asked for. Most of these are lost letters, not refusals.
- 4Step 4: Attach the documentation. The payer's original request letter, which says what and by when. Proof of what was sent and when, including the transmission record.
- 5Step 5: Send the appeal before the deadline. Send it to the payer with the claim, the denial and the documentation, inside the payer's appeal window. See what an appeal letter must contain and the filing limits by payer.
The common mistake. Do not resend the whole chart. A payer that asked for one operative note and receives ninety pages often denies again for the same reason.
Free: the Denial Code Appeal Playbook. 53 codes on one sheet: appeal, fix and resubmit, or let it go, and what to attach. Get the playbook
CO 226 description
The payer asked you for information and did not get it, or did not get enough.
The payer asked you for information and did not get it, or did not get enough. So the balance cannot move to the patient. Either the appeal recovers it or the practice absorbs it. That makes the appeal decision the whole decision on this line.
This is our plain-English wording, not the official X12 text. X12 asserts copyright over the published descriptions, so we write our own and say what it means for the money rather than restating the code.
Where this comes from. This is our own reading of the code, not the payer's and not a copy of the standards text. We classify it from how these denials actually resolve. Where we are unsure, we say so rather than guessing.
The Remark Code Beside It
The adjustment code says the claim was reduced. The remark code printed next to it says why, and it is the one that tells you what to send back.
| Remark | What it means |
|---|---|
| N706 | The payer says a document it needed never arrived. |
Related Codes
Your Questions Answered
What does CO 226 mean?
The payer asked you for information and did not get it, or did not get enough. Contractual obligation. The provider absorbs it and cannot bill the patient.
Can you appeal CO 226?
Usually recoverable. Find the original request, send exactly what it asked for, and send it in the format they asked for. Most of these are lost letters, not refusals.
Why does CO 226 happen?
A records request went to an old address or a fax nobody watches. Records were sent but arrived after the payer's clock ran out. What was sent did not include the specific item requested.
What documentation wins a CO 226 appeal?
The payer's original request letter, which says what and by when. Proof of what was sent and when, including the transmission record.
How do I appeal a CO 226 denial?
Step 1: Read the remark code. Find the remark code printed next to CO 226 on the 835 or EOB. It says what the payer wants back. Step 2: Find the cause. Match the denial to one cause: A records request went to an old address or a fax nobody watches. Records were sent but arrived after the payer's clock ran out. What was sent did not include the specific item requested. Step 3: Take the first action. Find the original request, send exactly what it asked for, and send it in the format they asked for. Most of these are lost letters, not refusals. Step 4: Attach the documentation. The payer's original request letter, which says what and by when. Proof of what was sent and when, including the transmission record. Step 5: Send the appeal before the deadline. Send it to the payer with the claim, the denial and the documentation, inside the payer's appeal window.
Most searched: CO 97 · CO 96 · OA 23 · PR 204 · CO 109 · CO 197 · CO 45 · CO 50
How Much of This Is Sitting in Your Write-Off Pile?
No patient data. No BAA. No charge.
Upload your denial summary for the last 90 days. 4 columns: payer, CARC code, count, billed amount. You get back which were winnable and what they were worth.