CO-250 denial code
The attachment received was the incorrect document
How to fix it
Identify what was actually requested and send exactly that, referencing the request.
How to prevent it
Match documentation to the specific request rather than sending the full record by default.
In practice
A payer requests the operative note for a specific procedure. The practice sends the full admission record, and the claim returns CO-250 stating the attachment was the incorrect document.
Sending more than was asked for is not a safer choice than sending exactly what was asked for. The reviewer is looking for a specific document, and a large record that does not obviously contain it reads as non-responsive.
Identify precisely what the request named and send that, referencing the request. Where the record is genuinely voluminous, indicating where the relevant portion sits makes the difference between a document received and a document read.
What sits behind it
The default of sending everything comes from a reasonable instinct and produces poor outcomes. It shifts the work of finding the relevant material onto a reviewer with no incentive to search, and it can expose information the request never sought.
There is a privacy dimension worth noting. Disclosing more than the request requires sits uncomfortably with minimum necessary principles, and a practice routinely sending complete records in response to narrow requests is over-disclosing as a matter of policy.
This code sits in a family with CO-251 for incomplete documentation and CO-163 for documents never received. Each represents a different failure in the same process, and each costs another cycle against a deadline that keeps running.
Related codes
Terms used here — Minimum Necessary · Appeal · HIPAA
How we handle it — Denial Management · Claims Management · AR Management
Primary sources
The rules behind CO-250, at the bodies that publish them.
- Evaluation and Management services guide (opens in a new tab)
Centers for Medicare & Medicaid Services — How E/M level is determined under the current medical decision making and time rules. The reference for any dispute about whether documentation supports a level.
- Medicare Claims Processing Manual (opens in a new tab)
Centers for Medicare & Medicaid Services — The operative manual for how Medicare claims must be coded, submitted, adjusted and appealed. When a payer policy and a vendor's advice disagree, this settles it.
- Medicare claims appeals process (opens in a new tab)
Centers for Medicare & Medicaid Services — The five levels of appeal, what each requires and the deadline for each. Missing a level's deadline ends the appeal regardless of the claim's merits.
Looking for a different code? Search all 190 CARC and RARC codes
Questions about CO-250
No, and it frequently produces this denial. A reviewer looking for a specific document treats a large undifferentiated record as non-responsive, and it also discloses more information than the request sought, which sits badly against minimum necessary principles.
Send the specific document and, where context is needed, indicate where the relevant portion sits. Making the material easy to find is the difference between a document that is received and one that is actually read.
CO-163 means nothing arrived, CO-250 means the wrong thing arrived, and CO-251 means what arrived was incomplete. Each is a different failure in the same process, and each consumes another cycle against a deadline that continues to run.
Find out what your denials are costing you
A free billing audit reviews your denial rate, AR aging and clean claim rate against industry benchmarks. Takes about two minutes to request. No sales pitch.
No setup fees · You pay when we collect · Pricing from 3% of net collections