CARC 16: Claim lacks information or has billing errors

Group code context

Often sent with group code CO. Read the RARC that comes with it, because it names the problem.

Common causes

• Missing or invalid NPI, taxonomy or referring provider
• Missing or invalid diagnosis code
• Subscriber ID or patient details do not match the payer's records
• Missing NDC for a drug code

Step-by-step fix

1. Read the RARC on the remittance (for example N290 or M76)
2. Fix the missing or wrong field
3. Resubmit as a corrected or new claim, following the payer's rule
4. Track it so it is not lost before the filing limit

Appeal guidance

This is rarely an appeal. It is a correction. Fix the data and resubmit.

When not to appeal

Do not file an appeal for missing information. Payers expect a corrected claim.

Prevention checklist

• Run claims through a scrubber before submission
• Check that provider NPIs and taxonomy codes are set up correctly in the PM system
• Scan insurance cards at every visit

Related codes

CARC 4: Modifier missing or inconsistent with the procedure code

CARC 31: Patient cannot be identified as the payer’s member

Source and review

Last checked: 2026-10-05