CO-27 — Expenses incurred after coverage ended
Claim-adjustment reason code 27 · typically reported as CO-27 or PR-27
What it means
The patient’s coverage with this payer terminated before the date of service.
Why DME claims hit it
- Ongoing rentals/resupply after a patient switched MA plans in January — the #1 DME version of this denial
- Disenrollment or death not caught before the next billing cycle
How to fix it
- Re-verify eligibility every rental/resupply cycle, especially Q1
- Find the new active payer and bill it (new auth may be required)
Appeal posture
Rarely — fix the payer targeting instead.
Related denial codes
CO-26 — Expenses incurred before coverage beganPR-31 — Patient cannot be identified as insuredCO-177 — Patient hasn’t met eligibility requirements
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