CO-96: Non-covered charges
UPDATED · U.S. PLANS · NOT LEGAL OR MEDICAL ADVICE
The payer classifies the service as not covered under the plan. Sometimes a true exclusion; sometimes a miscategorization of a covered service.
CO-96 at a glance
- Code group: CO — Contractual Obligation — in-network providers generally cannot bill you for CO adjustments.
- Who usually fixes it: You (the member).
- Worth appealing? Sometimes — depends on the facts.
What to do about a CO-96 denial
- Find the exact exclusion in your plan documents — ask the insurer to cite the provision.
- If the service was miscategorized (e.g., preventive billed as diagnostic), ask the provider to correct the coding.
- Appeal when the plan language actually covers your situation.
Best next read: How to appeal, step by step — the full guide (with a free letter template) for this denial type.
Denied? Don’t drop it
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