Denial Code 116 (CO-116, PR-116) — Meaning & What to Do
Claim Adjustment Reason Code (CARC)
What denial code 116 means: A pre-treatment estimate was given; this shows what would be covered.
What to do about denial code 116: Compare to the actual claim when it's processed.
CO-116 vs PR-116 vs OA-116: what the prefix means
| Code on your EOB | What the prefix means | Who typically pays |
|---|---|---|
| CO-116 | Contractual obligation — the provider writes the amount off | Usually not the patient |
| PR-116 | Patient responsibility | The patient |
| OA-116 | Other adjustment | Often another payer or plan |
The prefix tells you who is expected to absorb the amount; the number (116) tells you why.
Seeing denial code 116 on your EOB?
A denial code tells you what the payer reported, but it may not tell the whole story. Reviewing your EOB and bill together can help clarify what may need attention.
Related codes
CARC 115The procedure was postponed, canceled, or delayed.
CARC 117Transportation is only covered to the nearest appropriate facility.
CARC 114This procedure or service isn't covered when done at home.
CARC 118Charges were reduced for a specific health program requirement.
Keep reviewing your bill
- Medical Bill vs EOB: What Is the Difference?
- How to Dispute a Medical Bill — Find Billing Errors Before You Pay
- What Is an Itemized Medical Bill? How to Request One
Frequently asked questions about Denial code 116
What does denial code 116 mean on my EOB?
A pre-treatment estimate was given; this shows what would be covered.
What should I do about denial code 116?
Compare to the actual claim when it's processed.
Seeing this code on your own EOB?
Upload the EOB, the bill, or both — MD Bill Check reads the codes on your documents, compares them side by side, and flags what's worth questioning. Free, no account needed.