MCR - 835 Denial Code List
PR - Patient Responsebility
Here you can see all the denial codes .
PR - Patient Responsebility
Here you can see all the denial codes .
PR 1 Deductible Amount |
PR 2 Coinsurance Amount |
PR 3 Co-payment Amount |
PR 25 Payment denied. Your Stop loss deductible has not been met. |
PR 26 Expenses incurred prior to coverage. |
PR 27 Expenses incurred after coverage terminated. |
PR 31 Claim denied as patient cannot be identified as our insured. |
PR 32 Our records indicate that this dependent is not an eligible dependent as defined. |
PR 33 Claim denied. Insured has no dependent coverage. |
PR 34 Claim denied. Insured has no coverage for newborns. |
PR 35 Lifetime benefit maximum has been reached. |
PR 85 Interest amount. This change effective 1/1/2008: Patient Interest Adjustment (Use Only Group code PR) |
PR 126 Deductible -- Major Medical |
PR 127 Coinsurance -- Major Medical |
PR 140 Patient/Insured health identification number and name do not match. |
PR 149 Lifetime benefit maximum has been reached for this service/benefit category. |
PR 166 These services were submitted after this payers responsibility for processing claims under this plan ended. |
PR 168 Payment denied as Service(s) have been considered under the patient's medical plan. Benefits are not available under this dental plan |
PR 177 Payment denied because the patient has not met the required eligibility requirements |
PR 200 Expenses incurred during lapse in coverage |
PR 201 Workers Compensation case settled. Patient is responsible for amount of this claim/service through WC “Medicare set aside arrangement” or other agreement. (Use group code PR). |
PR 204 This service/equipment/drug is not covered under the patient’s current benefit plan |
PR B1 Non-covered visits. |
PR B9 Services not covered because the patient is enrolled in a Hospice. |
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