DenialCodePro
P11N/A - Pended claims in your system should not be submitted to MassHealth. If MCEs submit an encounter with this CARC, it will be rejectedGeneral Adjustment

Code P11

Problem Description

The disposition of the related Property & Casualty claim (injury or illness) is pending due to litigation. To be used for Property and Casualty only. (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.

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