835 Denial Combination

CO-96

CO

Contractual Obligation · Claim-Level Adjustment

Contractual Obligation

What This Combination Means

The payer has identified charges that are non-covered under the contract, but no specific remark code was included to explain why. This represents a contractual adjustment that the provider must write off, though the absence of a RARC means the specific reason for non-coverage is not documented on this remittance. The provider should reference their contract terms or contact the payer to understand which services or charges triggered this adjustment.

Financial Responsibility

provider writeoff

The provider is contractually obligated to write off the adjusted amount and cannot balance bill the patient for these non-covered charges.

N/A

Appeal Success

Immediate (write-off)

Avg. Resolution

Easy

Difficulty

No

Appealable

Step-by-Step Resolution

Steps tailored specifically to this CO-96 combination — not generic advice.

Not Appealable:This is a contractual adjustment for non-covered services per the provider's agreement with the payer, making it a non-appealable write-off.
  1. 1

    Review the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF) for the claim

    CARC 96 specifically instructs providers to check this segment for policy information explaining the non-covered determination

  2. 2

    Contact payer for missing RARC documentation

    CARC 96 requires at least one remark code, so request clarification on which contract provision or policy makes these charges non-covered

  3. 3

    Post contractual adjustment and write off the amount

    Apply the CO-96 adjustment to the patient account as a non-billable contractual write-off per payer agreement

Specialty Context

How CO-96 typically presents across different practice types.

Dental

Common for services excluded from medical-dental coverage boundaries (e.g., TMJ treatment billed to medical insurance) or cosmetic procedures explicitly excluded in dental contracts.

Medical

Frequently appears for experimental treatments, cosmetic procedures, or services listed as contract exclusions; absence of RARC may indicate generic non-covered determination.

Behavioral Health

May apply to court-ordered evaluations, non-clinical case management, or services exceeding benefit plan scope when mental health parity does not apply.

Individual Code References

View the standalone definition for each code in this combination.

Medicare Contractor Guidance for CARC 96

FCSO + Noridian

This denial is received when the service billed is statutorily excluded from coverage under the Medicare program. Payment cannot be made for the service under Part A or Part B.

How to Prevent CARC 96 Denials

  • Review the service billed to ensure the correct code was submitted.

  • If the claim is being submitted for statutorily excluded services, you can append a GY modifier to the line item. The GY modifier indicates that the item or service is statutorily excluded or does not meet the definition of a Medicare benefit.

Items & Services Not Covered Under MedicareStatutory exclusion from Medicare benefits - §1862(a)Noridian Medicare PortalCompetitive Bid HCPCS Lookup ToolCBA Zip Code Lookup ToolNMPModifier Lookup Tool

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Synthesized from official definitions — not from training data

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