163Denial Code (CARC)Active
CO 163 Denial Code - Fix Missing Documentation
Code 163 indicates that the attachment or other documentation that was referenced on the claim was not received by the payer. This means the claim can't be processed until the required information arrives.
Who Pays: Group Code Liability
With code 163, the group code is usually CO, meaning the provider must write off the amount. The patient is not responsible for the balance until the documentation issue is resolved.
Why Claims Get Code 163
- Attachment was not sent with the original claim submission.
- Documentation was sent but not associated with the claim by the payer.
- Incorrect or mismatched reference numbers between the claim and the documentation.
- The documentation was lost in transmission or not received by the payer.
How to Fix & Resubmit
- Verify that the documentation was sent with the claim and that the reference numbers match.
- Contact the payer to confirm whether they received the attachment or documentation.
- Resend the missing documentation with the correct reference numbers if it was not received.
- Ensure all required documentation is included before resubmitting the claim.
- Submit a corrected claim with the necessary documentation attached.
Corrected Claim or Appeal?
For code 163, a corrected claim with the proper documentation is typically required. Formal appeals are usually unnecessary unless the payer disputes receipt despite proof of submission.
Preventing Future 163 Denials
- Always attach required documentation with the initial claim submission.
- Double-check that reference numbers on claims and attachments match perfectly.
- Use electronic submission methods that confirm receipt of attachments.
- Maintain organized records of all documentation sent to payers.