PR-242 Denial Code: Official Description, Causes, and Step-by-Step Resolution
The PR-242 denial code appears on your 835 Electronic Remittance Advice as a pairing of two separate code components. PR is the Claim Adjustment Group Code, which X12 designates as Patient Responsibility. The number 242 is the Claim Adjustment Reason Code (CARC), which X12 officially defines as “Services not provided by network/primary care providers.” CARC […]