Denial codes / CO-22

Denial code 22

CO-22: Another insurer should pay first

May be covered by another payer (coordination of benefits).

What to doBill the right insurer
Often recoverableYes, when worked

The letters in front matter. CO means the office can't bill the patient for the amount; PR means the patient may owe it. The same number can appear with either, so read both parts.

Why dental offices see it

  • The patient has two plans and this one is secondary.
  • The birthday rule makes the other parent's plan primary for a child.
  • The insurer's coordination-of-benefits record is out of date.

What to do

  1. Confirm which plan is primary (birthday rule for children, employee plan before spouse's plan).
  2. Bill the primary first.
  3. Send the secondary claim with the primary's EOB attached.
  4. If the insurer's record is wrong, ask the patient to update it with the insurer.

Stop it next time

Ask about other coverage at every visit and record primary and secondary in the software.

How many CO-22 claims are in your report? The free check counts them, ranks them by dollars and deadline and drafts the letter. It runs in your browser; nothing is uploaded.

Run the free check

Plain-English paraphrase; the official code list is maintained by X12. Insurer rules vary; check the insurer's provider manual. Not legal advice.