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CO-290 Denial Code: Dental Plan Forwarded Claim to Medical

CO-290 means the patient's dental plan received the claim, found no benefits for the service under dental coverage, and forwarded it to the patient's medical plan for consideration. You don't need to resubmit yet; watch for the medical plan's decision.

Quick facts

Code
CO-290 (CARC 290)
Status
Active In use since November 1, 2017.
Code set
Claim Adjustment Reason Codes (CARC)
Group codes
  • CO (Contractual Obligation): The payer's usual group. The dental plan pays nothing and the balance isn't billable to the patient while the medical plan reviews it.
  • OA (Other Adjustment): Some payers use OA because the amount is simply moving to another plan, with no responsibility assigned yet.
Official description
Claim received by the dental plan, but benefits not available under this plan. Claim has been forwarded to the patient's medical plan for further consideration.
X12 Claim Adjustment Reason Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What CO-290 means

CARC 290 says the claim was received by the dental plan, but benefits are not available under this plan, and the claim has been forwarded to the patient’s medical plan. The dental carrier decided the service belongs under medical coverage and passed the claim along itself, which usually happens when the same company or a coordinated administrator handles both benefits.

The key word is forwarded. X12’s note says to use CARC 254 when the dental plan does not forward the claim. With CO-290, the next action belongs to the medical plan, and your job is mostly to follow up.

Example: a dentist removes a lesion and sends a biopsy. The dental plan excludes the service as medical and forwards it. A few weeks later, an ERA or letter should arrive from the medical plan with its own decision.

Common causes

  • Medically based procedures performed by a dentist or oral surgeon, such as biopsies or treatment of trauma.
  • Services the dental plan explicitly excludes as medical, per its plan documents.
  • Integrated dental and medical administrators that route claims between benefit sets automatically.

How to handle it

  1. Post the dental remittance with a zero payment and hold the balance; don’t bill the patient yet.
  2. Set a follow-up date to check the medical plan’s claim status.
  3. Prepare medical information: ICD-10-CM diagnoses, medical procedure codes, the referring provider if any, and clinical notes. Medical plans often ask for these on forwarded dental claims.
  4. If the medical plan has no record, submit a medical claim directly on a CMS-1500 or 837P, and keep the dental ERA as evidence of original filing.
  5. If the medical plan denies, work that denial on its own terms, such as medical necessity or authorization.
  6. Check enrollment. Your practice may need to be credentialed with the medical plan to be paid in-network.

How to prevent problems

  • Identify medical-dental crossover procedures before treatment and verify both coverages.
  • Get prior authorization from the medical plan when it’s required for the procedure.
  • Keep cross-coding references for the procedures you bill most often.
  • Track forwarded claims separately so they don’t age out while waiting.

Specialty notes

Oral and maxillofacial surgery practices see this code most. Dental offices that bill medical plans only occasionally should confirm they have a way to submit medical claims electronically before they need to.

Remark codes that may appear with CO-290

  • N130 (Consult plan benefit documents/guidelines for information about restrictions for this service.): Directs you to the dental plan's benefit documents that exclude the service.
  • CO-254 (Claim received by the dental plan, but benefits not available under this plan.): Same dental-plan outcome, but the claim was not forwarded. You must submit it to the medical plan yourself.
  • CO-291 (Claim received by the medical plan, but benefits not available under this plan.): The reverse direction: a medical plan forwarded the claim to the dental plan.
  • CO-289 (Services considered under the dental and medical plans, benefits not available.): Both dental and medical coverage were considered and neither pays.
  • CO-109 (Claim/service not covered by this payer/contractor.): Not covered by this payer; send to the correct payer.

CO-290 FAQ

Do I need to send a claim to the medical plan after CO-290?

Not right away. X12 says CARC 290 is used when the claim was forwarded; CARC 254 is used when it wasn't. Give the medical plan time to process, then check its status before sending anything, to avoid duplicates.

Will the medical plan have what it needs?

Often not. Dental claims carry CDT codes and tooth-level detail, while medical plans expect ICD-10-CM diagnoses and medical procedure codes. The medical plan may request information or deny for missing data, so be ready to supply it.

What if I never hear from the medical plan?

Call the medical plan or check its portal. If it has no record of the forwarded claim, submit a medical claim directly and keep the dental remittance as proof of timely filing.

Which services typically trigger CO-290?

Services with a medical basis done in a dental setting, such as some oral surgery, biopsies, treatment of jaw fractures, or care related to medical conditions.