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.
Seeing denial code 35 on your EOB?
A denial code tells you what the payer reported, but it may not tell the whole story. Reviewing your EOB and bill together can help clarify what may need attention.
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
- What Is an Itemized Medical Bill? How to Request One
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.
Seeing this code on your own EOB?
Upload the EOB, the bill, or both — MD Bill Check reads the codes on your documents, compares them side by side, and flags what's worth questioning. Free, no account needed.