CARC 239 Active

CO-239: Claim Spans Eligible/Ineligible Periods - Rebill Separately

TL;DR

Split the claim into eligible and ineligible periods and rebill each portion separately.

Action

Verify & Resubmit

Who Pays

Provider

Appeal

Patient Impact

None

Disclaimer

This content is for informational purposes only and does not constitute professional billing advice. Always verify information against your payer contracts and current coding guidelines. Consult a certified billing specialist for specific claim issues.

What Does CO-239 Mean?

With CO, the payer requires the claim to be split and rebilled. This is a billing instruction, not a coverage denial.

CARC 239 is similar to CARC 238 but requires a different resolution. Instead of automatically reducing the payment, the payer instructs the provider to split the claim into two separate submissions — one for the eligible period and one for the ineligible period. The payer cannot process the claim as a single submission when it straddles the eligibility boundary.

This is common for inpatient stays where coverage began or ended midway through the admission. The provider must rebill with the correct dates for each coverage period.

Common Causes

Cause	Frequency
Claim dates span coverage eligibility change requiring separate billing The claim's dates of service span a change in the patient's coverage eligibility, and the payer requires separate claims for the eligible and ineligible periods	Most Common
Service period spans plan year boundary The service dates cross a plan year boundary and the payer requires separate claims for each plan year	Common
Coverage type changed during service period The patient's coverage type changed (e.g., from one plan to another) during the service dates and separate claims are needed for each coverage period	Common

How to Resolve

Split the claim Create separate claims for the eligible and ineligible periods.
Rebill each portion Submit the eligible portion to the payer and handle the ineligible portion appropriately.

Do Not Appeal This Code

The claim spans eligible and ineligible periods of coverage. Split the claim into separate claims for each coverage period and resubmit. An appeal is not appropriate for this type of denial.

Common RARC Pairings

The RARC code tells you exactly what triggered the CO-239:

RARC	Description
MA130	Your claim contains incomplete and/or invalid information, and no appeal rights are afforded. Split the claim and resubmit as separate claims for each coverage period →

How to Prevent CO-239

Verify eligibility dates before submitting claims that span multiple periods
Split claims proactively when you know they cross eligibility boundaries

General Prevention

Verify coverage dates before submitting claims that span long service periods
Check for coverage changes at plan year boundaries
Split claims proactively when services span known coverage change dates
Implement billing system edits that flag claims spanning potential eligibility changes

Also Filed As

The same CARC 239 may appear with different Group Codes:

OA-239 PR-239

Related Denial Codes

CO-26 — Expenses Incurred Prior to Coverage CO-27 — Expenses Incurred After Coverage Terminated CO-31 — Patient Cannot Be Identified as Insured CO-32 — Patient Not Eligible Dependent CO-33 — Insured Has No Dependent Coverage

Sources

https://x12.org/codes/claim-adjustment-reason-codes
https://portal.ct.gov/-/media/ohs/health-it-advisory-council/apcd-advisory-group/data-submission-guide-workgroup/meeting-materials/6-30-22/carc-codes_final.pdf
https://www.aapc.com/resources/claim-adjustment-reason-codes
Codes maintained by X12. Visit x12.org for official definitions.