CO 269 denial code

Claim adjustment reason code 269. Often reported as CO 269.

Anesthesia not covered for this service

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 269 means

The payer does not cover anesthesia for the procedure it was billed with, so the anesthesia charge was adjusted.

The procedure itself may be covered, but the payer's policy does not pay for anesthesia with it. That is common for minor procedures, certain endoscopies, or some dental and office services.

The payer may point to the specific policy in the Healthcare Policy Identification segment (loop 2110 REF) of the 835, so check the electronic remittance for a policy number.

Group codes seen with 269

On a remittance, 269 comes after a group code. These are the ones it is most often reported with:

• CO 269 (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

• The payer's policy does not allow anesthesia for that procedure.
• Medical necessity for anesthesia was not supported for that patient.
• The anesthesia claim was linked to the wrong procedure code.

What to do next

1. Look for a policy reference on the 835 and read that policy.
2. Confirm the surgical procedure code linked to the anesthesia service is correct.
3. Appeal with documentation of why anesthesia was needed if the patient's condition supports it.

Related codes

• 50 (reason code) Not medically necessary per the payer
• 96 (reason code) Service not covered by the plan