Denial Code 256 (CO-256, PR-256) — Meaning & What to Do
Claim Adjustment Reason Code (CARC)
What denial code 256 means: This service isn't payable under a managed-care contract.
What to do about denial code 256: Ask the provider's billing office to explain or correct this, and resubmit if needed.
CO-256 vs PR-256 vs OA-256: what the prefix means
| Code on your EOB | What the prefix means | Who typically pays |
|---|---|---|
| CO-256 | Contractual obligation — the provider writes the amount off | Usually not the patient |
| PR-256 | Patient responsibility | The patient |
| OA-256 | Other adjustment | Often another payer or plan |
The prefix tells you who is expected to absorb the amount; the number (256) tells you why.
Seeing denial code 256 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 253A federal sequestration (across-the-board) reduction was applied.
CARC 272Coverage/program guidelines weren't met.
CARC 251The attachment or documentation needed to process this is missing.
CARC 273Coverage or program limits have been exceeded.
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 256
What does denial code 256 mean on my EOB?
This service isn't payable under a managed-care contract.
What should I do about denial code 256?
Ask the provider's billing office to explain or correct this, and resubmit if needed.
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.