Claim adjustment reason code

Denial code CO-200 meaning

CARC 200, usually seen as CO-200: The service happened during a lapse in the patient's coverage.

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Reason code
CARC 200
Short name
Lapse in coverage
Plain meaning
The service happened during a lapse in the patient's coverage.
Group codes
CO-200: Contractual obligation. The provider absorbs the amount under its contract or the payer's rules. Do not bill the patient for it. PR-200: Patient responsibility. The patient, or a secondary payer, may owe the amount.

Plain-English summary written by Rivvi. X12 owns the CARC list and its exact wording, which is not reproduced here. Read it on the X12 CARC list (list dated November 1, 2025, checked October 23, 2026). This page does not decide how a claim is paid.

Common causes

  • Premiums were not paid, or coverage paused on that date.

What to check before resubmitting

  1. Check eligibility for the date of service.
  2. Bill the patient or another plan.

Related reason codes

Related pages

Questions

What does denial code CO-200 mean?

The service happened during a lapse in the patient's coverage. This is Rivvi's plain-English summary of CARC 200. X12's exact wording is on x12.org.

How do I fix CO-200?

Check eligibility for the date of service. Bill the patient or another plan.

Can I bill the patient for CO-200?

When it comes with group code PR, the patient or a secondary payer may owe the amount. When it comes with CO, the provider writes it off.

Which group codes come with CARC 200?

Most often CO (contractual obligation) or PR (patient responsibility). The group code, not the reason code, says who owes the amount.

What is the difference between a CARC and a RARC?

A claim adjustment reason code (CARC) says why a claim line was paid differently than billed. A remittance advice remark code (RARC) adds detail, such as which field is missing.

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