Code to Highest Level of Specificity

CARC/RARC Description
CO-16 Claim/service lacks information or has submission/billing error(s) which is needed for adjudication.
M81 You are required to code to the highest level of specificity.

 

Common Reasons for Message

  • Truncated (invalid) Diagnosis Code
  • Scanning Error (paper claim)

Next Step

  • Verify diagnosis codes submitted are valid
    • If there is a 5 digit code, do not use a 3 or 4 digit code
  • For paper claims, if all diagnosis codes submitted are verified and are valid, contact Provider Contact Center (PCC) to ensure there were no errors in scanning claim

Claim Submission Tips

View reason code list, return to Reason Code Guidance page.

 

Last Updated May 18, 2018