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CO-168 Denial Code (Deactivated): Medical Plan, Not Dental

CO-168 meant the services had been considered under the patient's medical plan, so no benefits were available under the dental plan. X12 deactivated it without naming a replacement; several active codes now describe dental and medical cross-plan situations.

X12 deactivated CARC168 on May 1, 2018. Payers should no longer use it on new remittances, but it can still appear on older ERAs, corrected claims, and appeals.

Quick facts

Code
CO-168 (CARC 168)
Status
Deactivated StoppedMay 1, 2018 (in use since June 30, 2005).
Code set
Claim Adjustment Reason Codes (CARC)
Group codes
  • CO (Contractual Obligation): The dental plan did not pay; the provider needed to pursue the medical plan.
Official description
Service(s) have been considered under the patient's medical plan. Benefits are not available under this dental plan.
X12 Claim Adjustment Reason Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What CO-168 meant

CARC 168 appeared on a dental remittance when the services had already been handled under the patient’s medical coverage. Because the medical plan had considered them, the dental plan paid nothing. It was common where one company administered both medical and dental benefits.

What replaced it

X12 did not name a successor. The active code set now includes a family of cross-plan codes that tell you where the claim should go and whether it was forwarded:

  • CO-254: received by the dental plan; submit to the medical plan.
  • CO-290: received by the dental plan; forwarded to the medical plan.
  • CO-289: considered under both plans, with no benefits under either.

If you still see CO-168

It will be in older dental remittances. Check whether the medical plan actually paid the service. If it did, the dental balance may be patient responsibility or a write-off, depending on your agreements. If the medical plan never received it, submit a medical claim with the required diagnosis and documentation, and keep an eye on the medical plan’s filing limit.

  • CO-254 (Claim received by the dental plan, but benefits not available under this plan.): Received by the dental plan, benefits not available; submit to the medical plan.
  • CO-290 (Claim received by the dental plan, but benefits not available under this plan.): Received by the dental plan, benefits not available; claim forwarded to the medical plan.
  • CO-289 (Services considered under the dental and medical plans, benefits not available.): Considered under both dental and medical plans, and benefits not available under either.

CO-168 FAQ

Which services commonly cross between dental and medical plans?

Examples include oral surgery after trauma, some treatment related to medical conditions, and certain procedures performed in a hospital. Plan terms decide which coverage applies.

What should I do with the claim?

Look at the medical plan's remittance for the same service. If the medical plan has not processed it, bill the medical plan using the appropriate medical claim format.