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Denial Code B16

CARC B16: 'New Patient' qualifications were not met

This is a Claim Adjustment Reason Code (CARC). CARCs explain why a payer adjusted or denied a claim line and appear with a group code (CO, PR, OA, PI). Codes appear on the EOB / ERA after a claim is adjudicated.

Reference only — CARC/RARC are national code sets updated periodically. Verify against the current official list before acting on a denial or appeal.

Related CARC codes

B13
Previously paid. Payment for this claim/service may have been provided in a previous payme…
B14
Only one visit or consultation per physician per day is covered
B15
This service/procedure requires that a qualifying service/procedure be received and covere…
B20
Procedure/service was partially or fully furnished by another provider
B22
This payment is adjusted based on the diagnosis
B23
Procedure billed is not authorized per your Clinical Laboratory Improvement Amendment prof…

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