CO 268 denial code

Claim adjustment reason code 268. Often reported as CO 268.

Claim crosses into a new year

Unofficial reference. This is our own plain-English explanation, not the official code text. Payer rules differ. Verify with the payer and the official X12 code list. AlphaPrefix is not affiliated with X12, CMS or any payer. Data last updated Nov 11, 2026.

What 268 means

Split the services at December 31 and send one claim for each year, because the payer will not price a claim across January 1.

Benefits such as deductibles and out of pocket maximums usually reset on January 1, and fee schedules often change too. A claim that runs from late December into January cannot be priced as one unit.

The fix is mechanical: bill the services from each calendar year on their own claim and resubmit.

Group codes seen with 268

On a remittance, 268 comes after a group code. These are the ones it is most often reported with:

• CO 268 (Contractual Obligation): The provider's side of the ledger. The reduction comes from the payer contract or a rule the provider has to follow, and the patient normally cannot be billed for it.

The payer chooses the group code for each adjustment, so the same reason code can appear with another group code on your remittance. Read the two together. More about group codes.

Common causes

• An inpatient or ongoing service period ran across December 31.
• A monthly or series bill included dates in both years.
• The billing system did not split the claim at the year boundary.

What to do next

1. Split the claim into one for each calendar year with the correct dates and charges.
2. Check eligibility and authorization for the new year before sending the second claim.
3. Review the payer's rules on interim or split billing for institutional stays.

Related codes

• 267 (reason code) Claim spans more than one month
• 16 (reason code) Missing information or billing error