Denial Code 53 (CO-53, PR-53) — Meaning & What to Do
Claim Adjustment Reason Code (CARC)
What denial code 53 means: Services by this type of provider aren't covered under the plan.
What to do about denial code 53: Confirm the provider is in-network and eligible under your plan.
CO-53 vs PR-53 vs OA-53: what the prefix means
| Code on your EOB | What the prefix means | Who typically pays |
|---|---|---|
| CO-53 | Contractual obligation — the provider writes the amount off | Usually not the patient |
| PR-53 | Patient responsibility | The patient |
| OA-53 | Other adjustment | Often another payer or plan |
The prefix tells you who is expected to absorb the amount; the number (53) tells you why.
Related codes
CARC 49This is a routine or preventive service the plan doesn't cover this way.
CARC 54Charges from multiple physicians for the same care were reduced.
CARC 44The charge was reduced because it was above the plan's fee schedule.
CARC 58The service should have been given in a different, approved setting.
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 53
What does denial code 53 mean on my EOB?
Services by this type of provider aren't covered under the plan.
What should I do about denial code 53?
Confirm the provider is in-network and eligible under your plan.
Found this code on your bill or EOB?
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