835 Denial Combination

CO-96

CO

Contractual Obligation · Claim-Level Adjustment

What This Combination Means

The claim was submitted with non-covered charges. One or more charges on the claim are for services not covered by the patient's plan.

N/A

Appeal Success

5-10 days

Avg. Resolution

Medium

Difficulty

No

Appealable

Step-by-Step Resolution

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

  1. 1

    Identify which specific service lines were denied as non-covered.

  2. 2

    Review the patient's plan documents to confirm the exclusion.

  3. 3

    Bill the patient for non-covered services per your financial policy.

  4. 4

    Do not write off non-covered services as contractual adjustments.

Specialty Context

How CO-96 typically presents across different practice types.

Dental

Verify the claim was submitted with non-covered charges per your dental plan contract and documentation requirements.

Medical

Confirm the claim was submitted with non-covered charges against payer policy and submit corrected claim as needed.

Behavioral Health

Apply behavioral health parity rules and confirm the claim was submitted with non-covered charges per MHPAEA standards.

Individual Code References

View the standalone definition for each code in this combination.

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