CO 16 Denial

[tmpearce]

Can someone please tell me what exactly MC is looking for when they deny a claim with a CO-16 denial code? I've had a few come back today and I have no idea what they want in order to get these claims paid.

Thank you,

Teresa

 

[Tracey Thompson]

In my experience with Medicare, the denial code CO-16 is typically used when more information is needed pertaining to the claim. This is not a specific type of information, and it could be different information is needed for each claim denied with this code. Without more information my advice would be to call Medicare and ask what information is needed in order to adjudicate each claim denied with CO-16 code.

Hope this helps!

 

[tmpearce]

Great!

Thanks for the information.

Teresa

 

[csandri]

Co-16

There should be another denial code along with the 16, this will specifically tell you what they need. if you can send me exactly what the remit shows for that claim, I can tell you what they need. Medicare is a pain sometimes and have several denial reason codes in different places on the remits.

 

[tmpearce]

After speaking with a MC rep this morning, turns out they needed a 25 modifier on the 99214 because they were bundling it with a B-12 injection. So, now I know better and will be more careful about it from now on.

Thanks!

 

[Medmiles001]

Hi, my name is mike