CO-160Contractual ObligationContractual
CO-160 Denial Code: Injury from excluded activity
The injury arose from an activity the plan excludes (hazardous hobbies, illegal acts, certain sports).
Why CO-160 happens
- ●Plan-specific activity exclusions matched to the injury mechanism
How to fix a CO-160 denial
- 1
Review the plan's exclusion list; appeal if the activity was mischaracterized
- 2
Otherwise pursue patient responsibility or applicable liability coverage
How to prevent it
Capture mechanism of injury carefully — vague documentation invites exclusion fishing.
Drowning in CO-160 denials?
OakClaim works every denial within 48 hours and builds prevention rules so they stop recurring.