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Office Managers, Medical Billers and Medical Coders
What is the meaning of the CMS Medicare Claim Denial Reason Code?:
PR/19 , PR-19, PR19
 

    What is the meaning of the CMS Medicare Claim Denial Reason
    Code?: PR/19 , PR-19, PR19    -  This claim is denied because the
    rendered services may be related to a Workers Compensation Injury
    or Illness. Please submit the claims to Workers Compensation
    Carrier.


    What You Should DO:

    Verify it with your patient if this is really related to workers compensation
    injury or illness. If it is, you must submit the claims to the workers
    compensation carrier. Otherwise, you can reach Medicare's  REOPENING
    line and inform them that the claims is not related to workers compensation
    injury or illness.



    Useful References:  CPT Code Books, CMS Website (www.cms.gov),
    CCI Quarterly Updates, CPT Assistant Publications, Diagnosis Code
    Books
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