DenialCodePro
209Denial CodeGeneral Adjustment

Code 209

Problem Description

Per regulatory or other agreement. The provider cannot collect this amount from the patient. However, this amount may be billed to subsequent payer. Refund to patient if collected. (Use only with Group code OA)

Actionable Fix — Solution Steps

Verify claim details and patient demographics. Submit a corrected claim or appeal with necessary supporting medical documentation.

Related Codes in General Adjustment

1

Deductible Amount

2

Coinsurance Amount

3

Co-payment Amount

6

The procedure/revenue code is inconsistent with the patient's age. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

This directory provides reference information only and does not constitute official legal, medical, or financial billing advice. Always consult the payer's official remittance advice and current coding guidelines.

Send Us Feedback

Found a typo, have a suggestion, or need a code added? Let us know.