CARC 110 Active

PR-110: Billing Date Predates Service Date

TL;DR

Patient responsibility — review the adjustment and determine if the patient truly owes this amount.

Action
Review & Decide
Who Pays
Patient
Appeal
No
Patient Impact
Direct Financial
Disclaimer
This content is for informational purposes only and does not constitute professional billing advice. Always verify information against your payer contracts and current coding guidelines. Consult a certified billing specialist for specific claim issues.

What Does PR-110 Mean?

With PR (Patient Responsibility), the CARC 110 adjustment for billing date predates service date shifts the financial impact to the patient. Before billing the patient, verify that the denial reason is valid. if the underlying issue can be corrected, resubmit the claim first to potentially eliminate the patient's liability.

CARC 110 is used when the payer determines that billing date predates service date. The claim could not be processed as submitted because required information was absent, incomplete, or did not meet the payer's submission standards.

Common scenarios that trigger this adjustment include: the claim was electronically submitted or received by the payer before the date of service listed on the claim, which is a billing integrity violation; A data entry error placed the wrong date of service on the claim, making it appear as though the service has not yet occurred at the time of billing; The date fields in the electronic claim were formatted incorrectly, causing the payer's system to interpret the dates as the billing date predating the service date. The group code paired with CARC 110 determines who bears the financial responsibility — CO places it on the provider as a contractual obligation, PR shifts it to the patient, OA indicates a coordination of benefits or other payer adjustment.

How to Resolve

  1. Review the adjustment Examine the PR-110 adjustment and any RARC codes to understand the basis for the patient responsibility.
  2. Verify the adjustment is correct Confirm the PR designation and amount are appropriate based on the patient's plan benefits.
  3. Appeal if incorrect If the adjustment appears incorrect, file an appeal with supporting documentation.
  4. Collect from the patient if valid If the adjustment is confirmed correct, generate a patient statement and follow standard collection procedures.
Do Not Appeal This Code

This is a billing date error, not a denial. Correct the date of service on the claim and resubmit.

How to Prevent PR-110

Also Filed As

The same CARC 110 may appear with different Group Codes:

CO-110 OA-110

Related Denial Codes

PR-13 — Date of Death Precedes Date of Service PR-14 — Date of Birth Follows Date of Service PR-19 — Workers' Compensation Claim PR-20 — Liability Carrier Responsible PR-21 — No-Fault Carrier Responsible

Sources

  1. https://www.cms.gov/medicare/claims-appeals/organization-determinations
  2. https://www.aapc.com/resources/claim-adjustment-reason-code-carc
  3. https://www.mdclarity.com/denial-code/110
  4. Codes maintained by X12. Visit x12.org for official definitions.