CARC 96 is one of the broadest denial codes on the books. On its own, it only tells you the charge is non-covered. It does not tell you why. The actual reason lives in the remark code paired with it, and reading that remark code correctly is the difference between a two-minute write-off and a winnable appeal. This guide walks through how to separate the two, and how to protect revenue when an Advance Beneficiary Notice (ABN) is or is not already on file.
What the full brief covers
Signed-in members see the full brief. Here is what it contains.
- Read the paired remark code first
- Not covered by policy vs. not medically necessary
- The role of the ABN and patient responsibility
- Writing the appeal
- Non-covered service appeal letter template (fillable Word download)