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.
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
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.
Found this code on your bill or EOB?
Upload the document — MD Bill Check decodes every code, checks the math line by line, and explains what's worth questioning.