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CO-268 Denial Code: Claim Spans Two Calendar Years

CO-268 means the claim spans two calendar years, and the payer wants one claim per calendar year. Split the services at December 31 and resubmit as separate claims so each year's deductible, benefits, and fee schedule apply correctly.

Quick facts

Code
CO-268 (CARC 268)
Status
Active In use since November 1, 2014.
Code set
Claim Adjustment Reason Codes (CARC)
Group codes
  • CO (Contractual Obligation): The standard group. It's a billing format issue for the provider to fix; the patient isn't responsible.
Official description
The Claim spans two calendar years. Please resubmit one claim per calendar year.
X12 Claim Adjustment Reason Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What CO-268 means

CARC 268 says the claim spans two calendar years; please resubmit one claim per calendar year. The payer won’t adjudicate a claim that includes December and January dates together. Unlike most codes, the official text tells you exactly what to do: split it.

The reason is practical. At the turn of the year, several things can change at once:

  • Deductibles and out-of-pocket maximums often reset.
  • Fee schedules and rates are updated.
  • Procedure and diagnosis code sets change, with codes added, revised, or deleted.
  • Coverage may change if the patient’s plan or employer renewed.

A single claim can’t apply two sets of rules. Splitting it lets the payer process each year’s services under the right terms.

Common causes

  • Inpatient or residential stays crossing December 31, billed on one claim where the payer requires a year-end split.
  • Monthly or periodic billing where the cycle runs mid-December to mid-January.
  • DME rentals, home health, or hospice billed with spans that include the new year.
  • Recurring therapy services grouped on a line with a date range.

How to fix it

  1. Split services at December 31. One claim for earlier dates, a second for January 1 onward.
  2. Recalculate units and charges for each claim.
  3. Check codes for the new year. Codes valid in December may have changed in January; use the right code for each date.
  4. Re-verify eligibility for January dates, in case coverage or plan changed.
  5. Submit both claims following the payer’s instructions for new versus corrected claims (resubmission code 7 in box 22 when replacing an adjudicated claim).
  6. Update patient estimates since the new year’s deductible may apply.

How to prevent it

  • Close billing cycles on December 31 for all span-based services.
  • Configure your billing system to split automatically at calendar year-end.
  • Load new-year code and fee updates before billing January dates.
  • Recheck eligibility for all active patients in early January. See eligibility and COB denials.

Specialty notes

Hospitals, skilled nursing facilities, hospice, home health, and DME suppliers are most exposed because they commonly bill date spans. Inpatient stays can follow different payer rules at year-end than outpatient spans, so check how each payer wants cross-year admissions billed.

Remark codes that may appear with CO-268

  • N62 (Dates of service span multiple rate periods.): The dates of service span multiple rate periods, which is common at year-end fee schedule changes.
  • CO-267 (Claim/service spans multiple months.): The claim spans multiple months, a stricter version of the same split requirement.
  • CO-239 (Claim spans eligible and ineligible periods of coverage.): The claim spans eligible and ineligible periods, often seen when coverage changes on January 1.
  • CO-181 (Procedure code was invalid on the date of service.): Procedure code invalid on the date of service, which can occur after annual code updates.
  • PR-1 (Deductible Amount): Deductible, which typically resets each calendar year and is one reason payers require the split.

CO-268 FAQ

Why do payers require one claim per calendar year?

Many plans reset deductibles and benefit limits on January 1, and fee schedules and code sets change at the start of the year. A claim crossing years can't be processed cleanly under both years' rules.

How do I split a claim for CO-268?

Create one claim for dates through December 31 and another starting January 1. Recalculate units and charges for each, and use codes valid on each date of service.

Does CO-268 affect patient balances?

It can. Once split, the January services may fall under a new deductible, so the patient's share may be different from what you estimated on the combined claim.

What if the plan year isn't the calendar year?

The code specifically refers to calendar years. Some plans use a different plan year, and a payer might use other codes or remarks to ask you to split at that boundary. Follow the remark codes and payer instructions.