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96
CO - Contractual ObligationCoverage
Denial Code CO-96: Non-covered Charge
What Does Code 96 Mean?
Non-covered charge(s). At least one remark code must be provided to explain the non-covered charges.
Group Code CO (Contractual Obligation): The provider has agreed to accept the payer's determination. The patient is generally not responsible for this amount.
Why Does This Happen?
The service is excluded from the patient's benefit plan or is considered non-covered by the payer.
How to Resolve It
- 1Review the RARC codes for more details
- 2Verify the patient's benefit plan for covered services
- 3If service should be covered, appeal with plan documentation
- 4Consider ABN (Advance Beneficiary Notice) for Medicare patients