skip to content
Thank you for visiting First Coast Service Options' Medicare provider website. This website is intended exclusively for Medicare providers and health care industry professionals to find the latest Medicare news and information affecting the provider community.
To enable us to present you with customized content that focuses on your area of interest, please select your preferences below:
Select which best describes you:
Select your location:
Select your line of business:
This website provides information and news about the Medicare program for health care professionals only. All communication and issues regarding your Medicare benefits are handled directly by Medicare and not through this website. For the most comprehensive experience, we encourage you to visit or call 1-800-MEDICARE. In the event your provider fails to submit your Medicare claim, please view these resources for claim assistance.
Join eNews       En Español
Text Size:
YouTube LinkedIn Email Print
Send a link to this page
[Multiple email adresses must be separated by a semicolon.]
Last Modified: 11/11/2022 Location: FL, PR, USVI Business: Part B

Avoiding denial reason code CO 22 FAQ

Q: We received a denial with claim adjustment reason code (CARC) CO 22. What steps can we take to avoid this denial?
This care may be covered by another payer per coordination of benefits.
A: You received this denial because Medicare records indicate that Medicare is the secondary payer.
To prevent this denial in the future, follow the steps outlined below to determine beneficiary eligibility. If the beneficiary has a primary payer, the claim must be sent to the primary payer for a determination before it is submitted to Medicare for possible secondary payment.
Ask the patient or patient representative to complete the Medicare Secondary Payer (MSP) Questionnaire external pdf file to help determine if Medicare is the primary or secondary payer. Place the completed questionnaire in the patient’s file.
Check patient eligibility and verify if Medicare is the secondary payer via SPOT or the interactive voice response (IVR) system.
To resolve the denial:
Refer to the patient’s file and review the MSP questionnaire if it was previously completed.
Contact the patient or patient representative and ask if insurance has changed. The MSP Questionnaire external pdf file may be completed again to help determine if Medicare is the secondary payer.
If the patient’s insurance has changed, note this in the patient’s file for future reference.
If the patient’s Medicare records need to be updated, you may place a conference call with the patient/representative and the MSP Contractor at 1-855-798-2627.
If the patient’s file is updated to indicate that Medicare is the primary payer on the date of service, resubmit the claim to Medicare.
If Medicare is the secondary payer, submit the claim to the primary payer. When the determination is received from the primary payer, submit the claim to Medicare for possible secondary payment.
Additional resources to help you prevent this denial:
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.