What does CO 16 denial code mean?

Claim/service lacks information
CO 16 Denial Code: Claim/service lacks information which is needed for adjudication. Insurance will deny the claim with denial reason code CO 16 accompanied with remarks code, whenever claims submitted with missing, invalid, or incorrect information.

What is co252?

That code means that you need to have additional documentation to support the claim. If it is an HMO, Work Comp or other liability they will require notes to be sent or other documentation.

What is a reason code used on an EOB?

What is a reason code used on an EOB? Reason codes appear on an explanation of benefits (EOB) to communicate why a claim has been adjusted. The letters preceding the number codes identify: Contractual Obligation (CO), Correction or reversal to a prior decision (CR), and Patient Responsibility (PR).

What is denial code CO 204?

CO-204: This service, equipment and/or drug is not covered under the patient’s current benefit plan.

What does denial code co-16 stand for?

Denial code co -16 – Claim/service lacks information which is needed for adjudication. Explanation and solutions – It means some information missing in the claim form. This code always come with additional code hence look the additional code and find out what information missing.

What’s the difference between co 18 and co 22?

The denial code CO 18 revolves around a duplicate service or claim while the denial code CO 22 revolves around the fact that the care can be covered by any other payer for coordination of the benefits involved. The denial code CO 24 describes that the charges may be covered under a managed care plan or a capitation agreement.

What does denial Code Co 45 stand for?

Denial code co – 45 – Charges exceed your contracted/legislated fee arrangement. Note: This adjustment amount cannot equal the total service or claim charge amount; and must not duplicate provider adjustment amounts (payments and contractual reductions) that have resulted from prior payer (s) adjudication

Can a claim be denied due to co code?

Due to the CO (Contractual Obligation) Group Code, the omitted information is the responsibility of the provider and, therefore, the patient cannot be billed for these claims. Additional information regarding why the claim is denied may be supplied through remittance advice remarks codes.