CO-96
CO · Contractual Obligation
CO-96 Denial Code: Charge isn't covered (see the paired remark code)
The service is not covered. CO-96 is a catch-all that almost always needs the accompanying RARC remark code to explain why it is not covered.
- Group code
- CO - Contractual Obligation
- Code type
- CARC
- Billable to patient?
- No - depends on the paired remark code
- Appealable?
- Depends on the paired remark code
- Category
- Coverage & Benefits
- Common pairing
- N130
On a remittance
CAS*CO*96*125.00On a paper EOB it shows as CO-96.What CO-96 means
CO-96 tells you a charge is non-covered, but like CO-16 it relies on the paired RARC (for example N130 or N431) to explain the specific reason. As a CO adjustment it is a write-off and cannot be billed to the patient unless the remark indicates patient liability. Read the RARC first to decide whether to correct, appeal, or write off.
Common causes
- The service is excluded or not covered under the plan or payer policy.
- A statutory or contractual exclusion applies, named by the paired RARC.
- A coverage condition (authorization, referral, site of care) was not met.
How to fix it
- Read the paired RARC remark code - it states the actual reason and your next step.
- If the remark points to a fixable issue (missing info, wrong code), correct and resubmit.
- If genuinely non-covered, write off the CO amount, or bill the patient only where a valid notice/ABN allows.
How to prevent it
- Verify coverage and policy rules for the service before the visit.
- Capture required referrals and authorizations up front.
- Track which services each payer treats as non-covered.
Depends on the paired remark codeWhether CO-96 is appealable depends entirely on the paired RARC. If the remark points to a coverable service or a correctable error, appeal or resubmit with documentation; pure statutory exclusions are not overturned.