Denial Code 226 (CO-226, PR-226) — Meaning & What to Do
Claim Adjustment Reason Code (CARC)
What denial code 226 means: The information requested from the provider wasn't received or was incomplete.
What to do about denial code 226: Ask the provider to send the requested records to the insurer.
CO-226 vs PR-226 vs OA-226: what the prefix means
| Code on your EOB | What the prefix means | Who typically pays |
|---|---|---|
| CO-226 | Contractual obligation — the provider writes the amount off | Usually not the patient |
| PR-226 | Patient responsibility | The patient |
| OA-226 | Other adjustment | Often another payer or plan |
The prefix tells you who is expected to absorb the amount; the number (226) tells you why.
Related codes
CARC 225A penalty was applied for not using electronic funds transfer.
CARC 227Information requested from the patient wasn't received.
CARC 223A mandated federal/state adjustment was applied.
CARC 231This service isn't paid separately when done on the same day as another.
Keep reviewing your bill
- Medical Bill vs EOB: What Is the Difference?
- How to Dispute a Medical Bill — Find Billing Errors Before You Pay
Frequently asked questions about Denial code 226
What does denial code 226 mean on my EOB?
The information requested from the provider wasn't received or was incomplete.
What should I do about denial code 226?
Ask the provider to send the requested records to the insurer.
Found this code on your bill or EOB?
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