Denial codes / PR-2

Denial code 2

PR-2: Coinsurance

Coinsurance amount.

What to doUsually the patient's share
Often recoverableUsually not

The letters in front matter. CO means the office can't bill the patient for the amount; PR means the patient may owe it. The same number can appear with either, so read both parts.

Why dental offices see it

  • The patient's percentage share for this procedure class (for example 50% for major services).
  • The insurer used the wrong benefit class for the procedure.

What to do

  1. Compare the percentage with the plan's benefit breakdown.
  2. If the class is wrong (basic billed as major), call or appeal for reprocessing.
  3. If correct, bill the patient with the EOB.

Stop it next time

Store each plan's coinsurance by procedure class so the estimate matches the payment.

How many PR-2 claims are in your report? The free check counts them, ranks them by dollars and deadline and drafts the letter. It runs in your browser; nothing is uploaded.

Run the free check

Plain-English paraphrase; the official code list is maintained by X12. Insurer rules vary; check the insurer's provider manual. Not legal advice.