PR-2 denial code
Coinsurance. The patient's share of the allowed amount, typically 20% under Medicare. Also not a denial.
PR — Patient Responsibility. The amount is the patient's to pay: deductible, coinsurance, or copay. These are not denials, and they are collectible.
Why you got it
- 1The plan's coinsurance percentage applied normally.
How do I fix a PR-2 denial?
- Bill the patient, or their secondary insurance if they have one.
How to stop the next one
Nothing to prevent. This is the plan design working as intended.
Our diagnosis scrubber will not catch this one. PR-2 is driven by procedure codes, modifiers, or eligibility rather than by the diagnosis set — and procedure-side checking needs an AMA CPT licence we do not hold yet. We would rather tell you that than sell you a tool that quietly misses your most common denial.
If denials like this are a volume problem rather than a one-off, the denial management page explains how the paid workspace catches the coding causes on every claim, and the free ICD-10-CM lookup shows the coding notes behind any diagnosis code on the remittance.