OA 290 denial code
Claim adjustment reason code 290. Often reported as OA 290 or CO 290.
Dental plan forwarded to medical plan
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 .
What 290 means
The dental plan decided the service is medical and sent the claim on to the patient's medical plan for you.
The dental payer received the claim, found no dental benefit, and forwarded it to the medical carrier. This differs from code 254, where the dental plan simply tells you to bill medical yourself.
Watch for the medical plan's response rather than resubmitting right away.
Group codes seen with 290
On a remittance, 290 comes after a group code. These are the ones it is most often reported with:
- OA 290 (Other Adjustment): Used for adjustments that are neither the provider's contractual write-off nor the patient's share. It often appears with coordination of benefits, for example when another payer already paid.
- CO 290 (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 service is covered under medical rather than dental benefits.
- The dental and medical plans are with the same payer or have a forwarding arrangement.
- Oral surgery or trauma care was billed to the dental plan.
What to do next
- Note on the account that the claim was forwarded to the medical plan.
- Watch for a medical remittance and follow up if none arrives in the usual time.
- Bill the medical plan directly only if it confirms it did not receive the forwarded claim.
Related codes
- 254 (reason code) Dental plan: bill the medical plan
- 291 (reason code) Medical plan forwarded to dental plan
Source
Official wording: X12 Claim Adjustment Reason Codes list. The explanation on this page is our own plain-English wording, not the X12 text.
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