EOB denial code CO-96: what it means

What it means

This service is not covered under your plan. An accompanying remark code usually explains why.

Contractual Obligation — an adjustment the provider agreed to by contract. The patient is generally not billed for CO amounts.

Official X12 description

“Non-covered charge(s)”

Typical cause

The service is excluded by your plan, or a remark code (N- or M-) gives a more specific reason such as a benefit exclusion.

What to do next

1. 1Look for the remark code next to CO-96/PR-96 — it names the specific reason.
2. 2Check your plan documents to confirm whether the service is genuinely excluded.
3. 3If you believe it should be covered, file an internal appeal citing your plan's covered-benefits language.