What is a PR 55 denial code?
Asked by: Dr. Thaddeus Krajcik DDS | Last update: April 9, 2025Score: 4.9/5 (15 votes)
What is condition code 55?
Code. Description. 55. Date of death (required with Patient Discharge Status Code 20 (expired))
What does denial code PR mean?
PR (Patient Responsibility) is used to identify portions of the bill that are the responsibility of the patient. These could include deductibles, copays, coinsurance amounts along with certain denials. If the patient did not have coverage on the date of service, you will also see this code.
What does PR 50 mean?
A: This denial reason code is received when a procedure code is billed with an incompatible diagnosis for payment purposes, and the ICD-10 code(s) submitted is/are not covered under an LCD or NCD.
What is denial code PR 56?
Denial code 56 is used when a procedure or treatment has not been considered "proven to be effective" by the payer. This means that the insurance company does not believe that the specific procedure or treatment is necessary or beneficial for the patient's condition.
3 Common Denial Codes in Medical Billing
What is PR 55 reason code?
PR-55 Code – Invalid Procedure Code/Modifier Used Much like the PI-4 code, this code indicates a procedure or modifier inconsistency. Used when multiple surgeries or concurrent care lead to an adjustment in the billed amount. This denial emerges when there's an issue with the authorization number.
What is denial code 55?
What is Denial Code 55. Denial code 55 is used when a procedure, treatment, or drug is considered experimental or investigational by the payer. This means that the payer does not consider the specific procedure, treatment, or drug to be proven or established as effective for the patient's condition.
What does PR 60 mean?
MS 60-70 (Mint State) refers to a coin minted for regular distribution that was never actually put into circulation. PR 60-70 (Proof Coin) Proof coins graded 60 to 70 are mirrored to those of uncirculated grades with the difference that the coin was not made for circulation.
What does SPR 50 mean?
The SPF (Sun Protection Factor) scale is not linear:
• SPF 15 blocks 93% of UVB rays. • SPF 30 blocks 97% of UVB rays. • SPF 50 blocks 98% of UVB rays.
What is a PR 58 denial code?
Denial code 58 means the treatment was done in the wrong place.
What does PR code mean?
A PR code is a production code given to each piece of equipment installed in your vehicle and is used by manufacturers including VW, Audi, Seat, and Skoda. PR Codes contain three characters comprising of letters and numbers. An example of a PR code is 1KY and it may refer to the vehicle's brakes.
What is PR 100 denial?
Denial code 100 is when the payment is made directly to the patient, insured, or responsible party instead of the healthcare provider.
What is 55 code for?
Brazil Country Code 55 - Worldometer.
What is error 55?
First, try googling your motherboards brand and model followed with errorcode 55, and you would find out that your problem was that "The Memory could not be detected. Please re-install the memory and CPU. If the problem still exists, please install only one memory module or try using other memory modules.".
What does response code 55 mean?
The customer's card issuer has declined the transaction as the customer has entered an incorrect PIN. The customer should re-enter their PIN.
What does PR 70 mean?
PR70 coins from CAC, NGC, and PCGS. Image: CoinWeek / BullionShark. By Charles Morgan and Hubert Walker for CoinWeek Notes ….. PR70, PF70, or Proof 70, is the highest possible grade that a Proof coin can earn and as such is the highest Proof grade in the Sheldon Grading Scale.
What does 60 PR mean?
A PR BPM (Pulse Rate Beats Per Minute) of 55 is considered low, as the normal range is typically 60-100 beats per minute. This could be normal for some individuals, especially athletes, but it might also indicate bradycardia or other issues.
What does PR 63 mean?
Mint State or Proof 63. MS/PR-63. Average or slightly weak strike with moderate marks or hairlines. Mint State or Proof 62. MS/PR-62.
What is the remark code 55?
Remark code N55 indicates that the claim submitted did not adhere to the established billing procedures regarding group, referring, or performing providers. This typically means that there may have been an error or omission related to the identification or documentation of the providers involved in the patient's care.
What is PR code 50?
Assuming '50' is a CO-50 or PR-50, it means "These are non-covered services because this is not deemed a 'medical necessity' by the payer. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present."
What is a PR 25 denial code?
Denial code P25 is used when a payment is adjusted based on the Medical Provider Network (MPN). If the adjustment is at the claim level, the payer must send and the provider should refer to the 835 Class of Contract Code Identification Segment (Loop 2100 Other Claim Related Information REF).
What is error code 55?
The definition of this error means that the RAM is not installed. However, not every Q Code 55 error indicates a memory problem. In some cases, incompatibilities may also exist between the processor and the motherboard.
What is the condition code 55?
This is a reminder that when you are submitting a discharge status code on a claim of 20 (expired), 40 (expired at home), 41 (expired in a medical facility), or 42 (expired - place unknown), the claim is also required to have an occurrence code of 55, along with a date of death.
What is the PR 26 denial code?
What is Denial Code 26. Denial code 26 means that the expenses incurred by the patient were before their insurance coverage became effective.