Denial codes / CO-16
Denial code 16CO-16: Missing or incorrect information
Claim lacks information or has a submission/billing error.
What to doFix and resend
Often recoverableYes, when worked
The letters in front matter. CO means the office can't bill the patient for the amount; PR means the patient may owe it. The same number can appear with either, so read both parts.
Why dental offices see it
- Missing tooth number, surface or quadrant.
- Wrong subscriber ID, date of birth or relationship.
- Missing or wrong billing or treating provider NPI.
- Missing remark-code item such as a prior placement date.
What to do
- Read the remark code (RARC) on the EOB; it names what is missing.
- Correct the claim in your practice software.
- Send a corrected claim (not a new claim) and note the original claim number.
Stop it next time
Run a claim scrub before sending: tooth, surface, NPI, subscriber details. CO-16 is usually the fastest money in an aging report.
How many CO-16 claims are in your report? The free check counts them, ranks them by dollars and deadline and drafts the letter. It runs in your browser; nothing is uploaded.
Plain-English paraphrase; the official code list is maintained by X12. Insurer rules vary; check the insurer's provider manual. Not legal advice.