AGAR Guide
CARC16ReferenceCurrentVerified Aug 15, 2026

CARC 16

AR Guide Workflow

Missing Information

The claim was missing required information or had a submission or billing error, so the payer could not process it. This is usually a correction, not an appeal.

Open denial workflow

AR Guide explanation

What it means

The payer could not process the claim as submitted because required information was missing or the claim had a submission or billing error. A remark code should accompany this code to explain what is missing.

AR Guide knowledge

Common denial category

Missing Information — The claim was missing required information or had a submission or billing error, so the payer could not process it. This is usually a correction, not an appeal.

AR Guide knowledge

Common causes

  • Missing or invalid modifier
  • Incorrect or missing patient/provider information
  • Incomplete coding or missing required fields
  • Claim rejected by an edit before adjudication

AR Guide knowledge

What AR should verify

  1. Read the remark code(s) that accompany CARC 16 to identify the exact issue
  2. Compare the claim to the original submission
  3. Check the claim scrubber/edit report for the flagged element

AR Guide knowledge

Recommended action

  1. Fix the specific flagged element and resubmit
  2. Do not resubmit an unchanged claim expecting a different result
  3. If the claim is unprocessable (e.g. MA130), correct it rather than appeal

AR Guide knowledge

Escalation

  • If the payer cannot identify the missing element, escalate to a supervisor with the full claim and remark details.

AR Guide knowledge

QA checkpoint

  • Document what was corrected so the resubmission can be audited
  • Verify the resubmitted claim clears the original edit

About this guidance: Note

AR Guide knowledge is general reference content written by our team — it is not payer-specific policy and never replaces the payer’s documentation or your contract. Always confirm specifics with the payer.