CO-B16Contractual ObligationCoding
CO-B16 Denial Code: New patient qualifications not met
Billed as a new patient, but the payer's records show the patient was seen within the new-patient window (3 years, same group/specialty).
Why CO-B16 happens
- ●Patient seen by a same-specialty group partner within 3 years
- ●Practice acquisitions merging patient histories
How to fix a CO-B16 denial
- 1
Rebill with the equivalent established-patient code
How to prevent it
New-patient checks against group-wide history, not just the individual provider's.
Drowning in CO-B16 denials?
OakClaim works every denial within 48 hours and builds prevention rules so they stop recurring.