CO-96 — Non-covered charge
Claim-adjustment reason code 96 · typically reported as CO-96 or PR-96
What it means
The item simply isn’t a covered benefit — statutorily excluded or outside the benefit category (read the paired remark code for which flavor).
Why DME claims hit it
- Comfort/convenience items (e.g., grab bars, most bathroom safety equipment) excluded from the Medicare DME benefit
- Items billed to Medicare that belong to another benefit (e.g., certain supplies under Part D)
How to fix it
- Confirm benefit category before delivery; use an ABN when Medicare exclusion is known so the patient can be billed
- Route to the correct benefit/payer when one exists
Appeal posture
Statutory exclusions are not winnable — protect yourself up front with the ABN.
Related denial codes
CO-204 — Not covered under the patient’s current benefit planCO-50 — Not deemed medically necessaryCO-55 — Experimental / investigational
Looking up an item instead? Browse the HCPCS code library for fee schedule amounts and PA flags.
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