Denial Code 104 (CO-104, PR-104) — Meaning & What to Do
Claim Adjustment Reason Code (CARC)
What denial code 104 means: A managed-care withholding was applied to the payment.
What to do about denial code 104: Usually a provider-plan matter, not your responsibility.
CO-104 vs PR-104 vs OA-104: what the prefix means
| Code on your EOB | What the prefix means | Who typically pays |
|---|---|---|
| CO-104 | Contractual obligation — the provider writes the amount off | Usually not the patient |
| PR-104 | Patient responsibility | The patient |
| OA-104 | Other adjustment | Often another payer or plan |
The prefix tells you who is expected to absorb the amount; the number (104) tells you why.
Related codes
CARC 102A major medical adjustment was applied.
CARC 107A related service or claim is required but wasn't found.
CARC 101A predetermination (pre-check of benefits) was already given.
CARC 108Adjusted under a rental/purchase rule for equipment.
Keep reviewing your bill
- Medical Bill vs EOB: What Is the Difference?
- How to Dispute a Medical Bill — Find Billing Errors Before You Pay
Frequently asked questions about Denial code 104
What does denial code 104 mean on my EOB?
A managed-care withholding was applied to the payment.
What should I do about denial code 104?
Usually a provider-plan matter, not your responsibility.
Found this code on your bill or EOB?
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