Claim adjustment reason code
Denial code CO-272 meaning
CARC 272, usually seen as CO-272: The plan's coverage or program guidelines were not met.
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- Reason code
- CARC 272
- Short name
- Coverage guidelines not met
- Plain meaning
- The plan's coverage or program guidelines were not met.
- Group codes
- CO-272: Contractual obligation. The provider absorbs the amount under its contract or the payer's rules. Do not bill the patient for it.
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
- A coverage condition for the service was not met.
What to check before resubmitting
- Read the payer's policy for the service.
Related reason codes
Related pages
Questions
What does denial code CO-272 mean?
The plan's coverage or program guidelines were not met. This is Rivvi's plain-English summary of CARC 272. X12's exact wording is on x12.org.
How do I fix CO-272?
Read the payer's policy for the service.
Can I bill the patient for CO-272?
With group code CO, no. CO means the provider absorbs the amount under its contract or the payer's rules.
Which group codes come with CARC 272?
Most often CO (contractual obligation). 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.