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CO-D8 Denial Code (Deactivated): X-Ray Availability Flag

CO-D8 meant the claim lacked an indicator that an x-ray was available for review. X12 deactivated it and directs payers to CARC 16 with remark codes, such as M129.

X12 deactivated CARCD8 on October 16, 2003. Payers should no longer use it on new remittances, but it can still appear on older ERAs, corrected claims, and appeals.

Code: CO-D8 (CARC D8)
Status: Deactivated StoppedOctober 16, 2003 (in use since January 1, 1995).
Code set: Claim Adjustment Reason Codes (CARC)
Group codes: CO (Contractual Obligation): The provider had to add the indicator; the denial was not a patient liability.
Official description: Claim/service denied. Claim lacks indicator that 'x-ray is available for review.'
X12 Claim Adjustment Reason Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What CO-D8 meant

CARC D8 was used when a claim needed a statement that an x-ray was available for the payer to review, and that statement was missing. It came up most often where coverage depended on radiographic evidence, and the payer wanted to know the image existed without receiving it on every claim.

What replaced it

X12’s note says to use code 16 and remark codes. The current pairing is CO-16 with remark M129, which flags a missing indicator of x-ray availability. If the payer also needs the date the x-ray was taken, it may add N326.

If you still see CO-D8

It only exists in older claim records. For a similar denial today, confirm that the x-ray exists in the patient’s record and note its date, then add the availability indicator or x-ray date as the payer’s claim instructions require and resubmit. Keep the image easy to retrieve in case the payer requests it later.

CO-16 (Claim/service lacks information or has submission/billing error(s).): Named replacement: claim lacks information, with a remark code.
M129 (Missing/incomplete/invalid indicator of x-ray availability for review.): Remark code for a missing, incomplete, or invalid indicator of x-ray availability for review.
N326 (Missing/incomplete/invalid last x-ray date.): Remark code for a missing, incomplete, or invalid last x-ray date.

CO-D8 FAQ

Why did payers want to know an x-ray was available?

For some services, historically including chiropractic claims where subluxation was demonstrated by x-ray, payers wanted assurance the image existed and could be produced on request.

Is the x-ray itself required with the claim?

Usually not. The indicator told the payer the image was on file and available if requested. Send the image only if the payer asks for it.

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