553-Medicaid Denial Code Update: CO200 / CO31

Dec 12, 2025

Medicaid Denial Code Update

Medicaid revised its denial reason for files processed and paid in November and replaced denial code CO200 with CO31. Providers will begin seeing CO31 denials in their Workable Claims queue within the Billing module. To support this change, PCG is implementing a system update that will automatically move CO31-denied claims to Escrow, using the same methodology previously applied to CO200 denials. Previously, CO200-denied claims would pend for eligibility determination. While eligibility was pending, these claims moved to Escrow for payment without waiting for the Medicaid denial. If eligibility was confirmed, affected claims would then be captured during the Medicaid sweep process. The same approach will now apply to CO31 denials. After the system update, CO31-denied claims will go directly to Escrow and will no longer appear in your Workable Claims queue. The update is expected to be implemented following the implementation of the Full Release and the 4% rate modifier for Underserved and Rural areas. No action is required from providers at this time. This notice is for awareness only. After the update, claims processed through Escrow will appear in your payment records as usual.

Article ID: 14, Created: 7/9/2026 at 9:00 AM, Modified: 7/9/2026 at 9:00 AM