270Denial Code (CARC)Active
CO 270 Denial Code - Resolve with Dental Plan
Code 270 means the claim was submitted to the patient's medical plan, but the services are only covered under the patient's dental plan. The medical plan has not provided benefits for these services, and you need to send the claim to the dental plan for processing.
Who Pays: Group Code Liability
For code 270, the group code is typically CO, as the provider must write off the amount from the medical plan. However, if there's a chance the patient did not provide accurate insurance information, it could be PR, making it the patient's responsibility to provide the correct details.
Why Claims Get Code 270
- The patient has a separate dental insurance plan not billed initially.
- The services rendered were dental in nature but billed to a medical plan.
- The patient provided incorrect insurance details at registration.
- The provider's billing system incorrectly routed the claim to the medical instead of the dental plan.
How to Fix & Resubmit
- Verify with the patient or their records whether they have a separate dental insurance plan.
- Contact the patient to obtain the correct dental insurance information if not available.
- Resubmit the claim to the patient's dental plan using the correct payer details.
- Ensure the claim includes all necessary documentation required by the dental plan.
- Follow up with the dental plan to confirm receipt and processing of the claim.
Corrected Claim or Appeal?
For code 270, do not appeal; instead, submit a corrected claim to the dental plan once the correct insurance information is confirmed.
Preventing Future 270 Denials
- Ensure accurate insurance information is collected from the patient at registration, including dental coverage.
- Train staff to identify services that should be billed to dental plans rather than medical plans.
- Update billing software rules to flag procedures that are typically dental in nature.
- Regularly review and update payer information for patients with dual coverage.