CO-96 Denial Code
What it means
The insurer says this service isn't covered by the plan. The paired remark code should say the specific reason.
Why it happens
The service is excluded from your benefits, lacks required authorization, or isn't covered for this diagnosis.
What to do
Read the paired remark code, then check your Summary of Benefits. If you believe it IS covered (or should be under a mandate), appeal citing the policy language.
Can you appeal it?
Yes, depending on the underlying reason.
Official description
Non-covered charge(s); often paired with a remark code explaining why.
Decode your full denial letter
Paste or upload your letter and get the deadline, escalation ladder, and a ready-to-send appeal letter - free during early access.
Decode your full denial letter