Can I appeal a CO-227 or PR-227 denial?

Yes. Appealing is free and it is your legal right. For this code the odds are high: Answering the request usually releases payment. Fewer than 1 in 100 denials are ever appealed — insurers count on silence.

Who has to pay after a code 227 denial?

Usually your cost to pay. The letters in front of the number matter: CO (contractual obligation) usually means an in-network provider must absorb it, while PR (patient responsibility) means the plan says you owe it.

How long do I have to appeal?

It depends on your coverage: 180 days for most employer and marketplace plans, 120 days for Original Medicare, about 90 days for Medicaid (varies by state), and only 65 days for Medicare Advantage. Set your deadline clock before you do anything else.

Denial code 227 · CO-227 / PR-227 · translated

Denial code 227: what it means — and how to fight it

Denial code 227 (shown on your EOB as CO-227 or PR-227) means: “Information requested from the patient/insured/responsible party was not provided or was insufficient.” In plain English: The insurer asked YOU for information (accident details, other-insurance forms) and hasn't gotten it.

high appealability Usually your cost to pay

What they're really saying

“Information requested from the patient/insured/responsible party was not provided or was insufficient.”

The insurer asked YOU for information (accident details, other-insurance forms) and hasn't gotten it.

Your odds

Strong — this type of denial has real weaknesses.

Answering the request usually releases payment.

Fewer than 1 in 100 denied claims are ever appealed. When people do appeal, roughly 4 in 10 win the first round — and independent external review overturns 40–50% of what reaches it.

How to appeal a code 227 denial

Decode. You just did — this page is step one.
Set your clock. 180 days for most employer and marketplace plans, 120 for Original Medicare, ~90 for Medicaid, only 65 for Medicare Advantage.
Urgent? If this is care you still need, call and request an expedited appeal — they must decide within 72 hours.
Find the insurer's information request in your mail/portal and answer it today. Complete the questionnaire they sent (often about other coverage or how an injury happened). Do it in writing and keep a copy.
Send it certified. Letter plus evidence, keep copies of everything.
Escalate. Denied again? Independent external review — a doctor who doesn't work for your insurer decides.

Do it in minutes, free

The AppealClock tool translates your denial, drafts your appeal letter, computes your exact deadline — and watches the clock so you don't have to. No account. Your medical details never leave your device.

Start your appeal & set your clock →

Common questions

What does denial code 227 mean?: The insurer asked YOU for information (accident details, other-insurance forms) and hasn't gotten it.
Can I appeal a CO-227 or PR-227 denial?: Yes. Appealing is free and it is your legal right. For this code the odds are high: Answering the request usually releases payment. Fewer than 1 in 100 denials are ever appealed — insurers count on silence.
Who has to pay after a code 227 denial?: Usually your cost to pay. The letters in front of the number matter: CO (contractual obligation) usually means an in-network provider must absorb it, while PR (patient responsibility) means the plan says you owe it.
How long do I have to appeal?: It depends on your coverage: 180 days for most employer and marketplace plans, 120 days for Original Medicare, about 90 days for Medicaid (varies by state), and only 65 days for Medicare Advantage. Set your deadline clock before you do anything else.