CO-96Contractual Adjustment
Non-covered charge
What this code means
This service or item is not covered under your health plan. This is one of the broadest denial codes and can cover a wide range of excluded services.
What to do next
Review your plan documents and Summary of Benefits to confirm the exclusion. If you believe the service should be covered, appeal with documentation. Also check whether your state has a mandate requiring coverage for this service.
Appeal outlook: Low to moderate depending on service type
Recommended tool
Bill Advantage can analyze your denial and generate a ready-to-send appeal or dispute letter in minutes.
Open Denial Letter Translator