Claim/Service Lacks Information or Has a Submission/Billing Error

What it means

The payer is saying your claim is missing something or has an error in how it was submitted or billed. This code alone doesn't tell you what's wrong — it's a pointer telling you to look at the accompanying remark code(s) on the same remittance advice for the actual reason.

Common causes

Missing or invalid patient demographic, insurance, or subscriber information
Missing required modifier, diagnosis pointer, or procedure code detail
Incomplete or missing prior authorization/referral number
Invalid or missing NPI, taxonomy code, or provider identifier
Missing supporting documentation the payer expected on submission
Coding or billing errors such as mismatched units, dates of service, or place of service
Claim submitted with incomplete or incorrect insured/patient relationship data

How to fix it

Locate the RARC (remark code) paired with CO-16 on the remittance advice — it identifies the specific missing item or error
Pull the claim and compare submitted data against the payer's requirements for that remark code
Correct the identified field (e.g., add modifier, fix NPI, add authorization number, correct date of service)
Verify patient eligibility and demographic data on file matches what was submitted
Resubmit the corrected claim following the payer's timely filing and resubmission guidelines
If documentation was requested, gather and submit the supporting records with the corrected claim

Appeal / resubmit

Before appealing, confirm you've identified and fixed the underlying issue flagged by the accompanying remark code — an appeal without correcting the root error is likely to be denied again. If the claim was actually complete and accurate, submit a reconsideration with a copy of the original documentation and a cover letter noting the information was present, referencing the specific remark code the payer cited.

Related codes

MA130
N56
N30

Frequently asked

Why did I get denial code 16 with no clear reason?

Code 16 always appears with one or more remark codes (RARCs) on the same remittance advice — those remark codes contain the specific detail about what information is missing or incorrect.

Can I just resubmit the same claim to fix this?

No. Resubmitting without correcting the specific issue identified by the remark code will likely result in the same denial. Identify and fix the flagged field first.

Does this mean the claim was rejected for medical necessity?

No. Code 16 is about missing or incorrect information/billing errors, not a medical necessity or coverage determination.

More free billing tools: all denial codes · denial lookup · Medicare fee calculator

This content is informational only and is not billing or legal advice. Always verify requirements with the specific payer and consult qualified compliance or billing professionals for your situation.