Denial Code 35 (CO-35, PR-35) — Meaning & What to Do
Claim Adjustment Reason Code (CARC)
What denial code 35 means: You've reached the lifetime benefit maximum for this service.
What to do about denial code 35: Confirm with your insurer; benefit maximums are sometimes tracked incorrectly.
CO-35 vs PR-35 vs OA-35: what the prefix means
| Code on your EOB | What the prefix means | Who typically pays |
|---|---|---|
| CO-35 | Contractual obligation — the provider writes the amount off | Usually not the patient |
| PR-35 | Patient responsibility | The patient |
| OA-35 | Other adjustment | Often another payer or plan |
The prefix tells you who is expected to absorb the amount; the number (35) tells you why.
Related codes
CARC 31The patient couldn't be identified as covered by this insurer.
CARC 39Authorization was requested but denied for this service.
CARC 26Expenses were incurred before your coverage started.
CARC 40This was billed as urgent/emergency care but wasn't approved as such.
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 35
What does denial code 35 mean on my EOB?
You've reached the lifetime benefit maximum for this service.
What should I do about denial code 35?
Confirm with your insurer; benefit maximums are sometimes tracked incorrectly.
Found this code on your bill or EOB?
Upload the document — MD Bill Check decodes every code, checks the math line by line, and explains what's worth questioning.