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What is a co16 denial code?

The CO16 denial code alerts you that there is information that is missing in order for Medicare to process the claim. 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.

What does co16 mean in medical billing?

For commercial payers, the CO16 can have various meanings. It is primarily used to indicate that some other information is required from the provider before the claim can be processed.

What to do if you receive a co16 from a payer?

When you receive a CO16 from a commercial payer, as stated above, the first place to look would be at any remark code present on the ERA, paper EOB or even the payer’s website. If the reason for the denial is not detailed enough in a remark code, the next step would be to contact the payer to see what information is required.

What is an n575 co16 denial?

N575: Mismatch between the submitted ordering/referring provider name and records. A CO16 denial does not necessarily mean that information was missing. It could also mean that specific information is invalid.


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