PI (Payor Initiated Reduction) Denial Codes

PI adjustments are payer-initiated reductions that are similar to CO but may carry different appeal rights depending on the payer and contract terms. Less common than CO or PR.

Common scenarios: Payer-initiated payment reductions. Adjustments with specific appeal rights under contract. Reductions that differ from standard contractual obligations.

Codes: 1 active Financial responsibility: Varies Patient billable: No
Disclaimer
This content is for informational purposes only. Always verify against your payer contracts and current coding guidelines.

All PI Denial Codes

Code Name Category Action
PI-278 Performance Program Proficiency Requirements Not Met other Review & Decide
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Other Group Codes

CO
Contractual Obligation
OA
Other Adjustment
PR
Patient Responsibility