CO-27: Expenses Incurred After Coverage Terminated
CO (Contractual Obligation)What is CO-27?
CO-27 is a Contractual Obligation code indicating the service was rendered after the patient's coverage end date. The patient's insurance had already terminated when the service was provided.
Why Does CO-27 Occur?
- Patient's coverage was terminated before the date of service due to non-payment, job change, or plan cancellation.
- COBRA coverage lapsed and was not renewed.
- Patient's employer terminated group coverage but the termination was not yet reflected in the payer's system.
How to Fix CO-27 Denials
- Verify the patient's coverage termination date on the payer portal.
- If the patient has new coverage, submit the claim to the new payer.
- If no coverage exists, bill the patient directly as self-pay.
- If the termination date is incorrect in the payer's system, appeal with proof of active coverage (e.g., premium payment receipts, employer confirmation).
CO-27 by Payer
| Payer | Common RARC | Appeal Deadline | Notes |
|---|---|---|---|
| UnitedHealthcare | Varies | 60 days from remittance | Reconsideration required before formal appeal. |
| Anthem | Varies | 365 days from denial notice | Check state-specific provider manual for variations. |
| Aetna | Varies | 180 days from denial | Strict in-network filing enforcement. |
| Cigna | Varies | 180 days from denial | Cigna COB team: 1-800-244-6224. |
| Medicare | Varies | 120 days (redetermination at MAC) | Five levels of appeal starting with MAC redetermination. |
Related CARC Codes
If you are seeing CO-27, check these related codes: CO-44 (subscriber not eligible), CO-27 (coverage terminated), CO-26 (prior to coverage).
Common Questions About CO-27
What does CO-27 mean?
CO-27 indicates expenses incurred after coverage terminated. Check the RARC code on the EOB for the specific reason and follow the resolution steps above.
Can I appeal a CO-27 denial?
Yes. Commercial payers allow 60-365 days to appeal depending on the payer. Gather supporting documentation before filing. Medicare allows 120 days for a redetermination request.
Altair catches CO-27 denials before submission with real-time eligibility checking. See how pre-submit claim scoring works.