Denial Code 49 (CO-49, PR-49) — Meaning & What to Do
Claim Adjustment Reason Code (CARC)
What denial code 49 means: This is a routine or preventive service the plan doesn't cover this way.
What to do about denial code 49: Check whether it should have been billed as preventive care.
CO-49 vs PR-49 vs OA-49: what the prefix means
| Code on your EOB | What the prefix means | Who typically pays |
|---|---|---|
| CO-49 | Contractual obligation — the provider writes the amount off | Usually not the patient |
| PR-49 | Patient responsibility | The patient |
| OA-49 | Other adjustment | Often another payer or plan |
The prefix tells you who is expected to absorb the amount; the number (49) tells you why.
Related codes
CARC 44The charge was reduced because it was above the plan's fee schedule.
CARC 53Services by this type of provider aren't covered under the plan.
CARC 40This was billed as urgent/emergency care but wasn't approved as such.
CARC 54Charges from multiple physicians for the same care were reduced.
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 49
What does denial code 49 mean on my EOB?
This is a routine or preventive service the plan doesn't cover this way.
What should I do about denial code 49?
Check whether it should have been billed as preventive care.
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.