Healthcare Error Code
Healthcare Insurance / Medical Billing
Claim Adjustment Reason Codes (CARC)

CO-27 | Coverage terminated

Industry
Healthcare
Canonical
/healthcare/error-codes/co-27/
Last Updated
Feb 25, 2026
Summary

This code indicates that the patient’s insurance coverage was not active on the date of service.

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What This Code Means

CO-27 is applied when a payer determines that coverage had ended before the service date. The claim is denied because the policy was no longer in force at the time services were rendered. This is a coverage status issue rather than a service-level determination. It does not indicate that the service was inappropriate or incorrectly billed. Coverage termination may occur due to policy expiration, cancellation, or eligibility changes.

Where Users Usually See This Code

  • Explanation of Benefits (EOB)
  • Remittance advice
  • Eligibility and claim status portals

Why This Code Appears

  • Policy coverage ended prior to service date
  • Eligibility records were not updated in time
  • Coverage lapsed due to non-renewal

What Typically Happens Next

  • The claim is denied by the payer
  • Responsibility may shift to another insurer or the patient
  • The claim is closed unless redirected

What This Code Is Not

  • It is not a non-covered service determination
  • It is not a billing format error
  • It is not a temporary processing delay

Troubleshooting Checklist

  • Verify coverage dates
  • Review eligibility confirmation records
  • Check for alternate or secondary coverage

Notes And Edge Cases

Coverage may terminate retroactively in some situations. Coordination of benefits issues can temporarily trigger this code until corrected.

Related Codes

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