CO-96Contractual ObligationEligibility
CO-96 Denial Code: Non-covered charge(s)
Non-covered charge(s). The service is excluded from the patient's plan benefits. A remark code usually specifies why.
Why CO-96 happens
- ●Service is a plan exclusion (cosmetic, experimental, etc.)
- ●Benefit category not included in the member's plan
- ●Wrong code making a covered service look non-covered
How to fix a CO-96 denial
- 1
Read the remark code and check plan benefits
- 2
Correct coding if the service is actually covered
- 3
Bill the patient if it is a true exclusion and notice requirements were met
How to prevent it
Verify benefits (not just eligibility) for the specific service before rendering it.
Drowning in CO-96 denials?
OakClaim works every denial within 48 hours and builds prevention rules so they stop recurring.