835 Denial Combination
CO-96+N115
Contractual Obligation · Service-Line Level Adjustment
What This Combination Means
Medicare does not pay for this item or supply.
N/A
Appeal Success
7-14 days
Avg. Resolution
Medium
Difficulty
No
Appealable
Step-by-Step Resolution
Steps tailored specifically to this CO-96+N115 combination — not generic advice.
- 1
A Redetermination request may be submitted with all relevant supporting documentation. Noridian encourages Redeterminations/Appeals be submitted using the Noridian Medicare Portal. Review applicable Local Coverage Determination (LCD), LCD Policy Article, and Documentation Checklists prior to submitting request.
Specialty Context
How CO-96+N115 typically presents across different practice types.
Dental
Medical
Behavioral Health
Individual Code References
View the standalone definition for each code in this combination.
Medicare Contractor Guidance for CARC 96
FCSO + NoridianThis denial is received when the service billed is statutorily excluded from coverage under the Medicare program. Payment cannot be made for the service under Part A or Part B.
How to Prevent CARC 96 Denials
- ✓
Review the service billed to ensure the correct code was submitted.
- ✓
If the claim is being submitted for statutorily excluded services, you can append a GY modifier to the line item. The GY modifier indicates that the item or service is statutorily excluded or does not meet the definition of a Medicare benefit.
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