CARC B16 denial code: meaning & whether to appeal (verified)
What CARC B16 means
'New Patient' qualifications were not met.
Verbatim description from the official X12 Claim Adjustment Reason Codes list.
Classification
Denial class: downcoding
Appealability verdict
Appealable — downcoding
What to know
Appealable when the clinical documentation supports the level billed; the appeal presents the record as billed and asks for reprocessing at that level.