835 Denial Combination

CO-16+M60

CO

Contractual Obligation · Service-Line Level Adjustment

What This Combination Means

Claim/service lacks information or has submission/billing error(s)

N/A

Appeal Success

7-14 days

Avg. Resolution

Medium

Difficulty

No

Appealable

Step-by-Step Resolution

Steps tailored specifically to this CO-16+M60 combination — not generic advice.

  1. 1

    A Redetermination request may be submitted with all relevant supporting documentation. Noridian encourages Redeterminations/Appeals be submitted using the Noridian Medicare Portal. Review applicable Local Coverage Determination (LCD), LCD Policy Article, and Documentation Checklists prior to submitting request

Specialty Context

How CO-16+M60 typically presents across different practice types.

Dental

Medical

Behavioral Health

Individual Code References

View the standalone definition for each code in this combination.

CARC 16RARC M60

Medicare Contractor Guidance for CARC 16

FCSO + Noridian + uhc + aetna + bcbs_az

This RUC is received when a claim is submitted with missing, incorrect, or invalid information. For details pertaining to your claim, please refer to the remittance advice remark codes (RARCs) on the remittance advice (RA).

How to Prevent CARC 16 Denials

  • ✓

    Review the RARC on the remittance advice to identify which specific field has the error.

  • ✓

    Per Medicare guidelines, claims must be filed no later than 12 months after the date of service. RUCs are not considered filed/submitted.

CMS guidelines for completion of form CMS-1500 in the Medicare Claims Processing Manual (100-04), Chapter 26SPOTFee Schedule Lookup ToolCMS laboratory demographics lookupModifier lookup toolNoridian Medicare PortalNMPIVRSame or SimilarPECOSPDAC

Need to resolve this denial?

Get a complete resolution plan with appeal guidance for this exact combination in seconds.

Generate a free resolution plan & appeal letter →

Was this helpful?
← Back to Combo LookupBrowse All Codes →