PR-135: Interim Bills Cannot Be Processed

What Does PR-135 Mean?

With PR (Patient Responsibility), the CARC 135 adjustment for interim bills cannot be processed 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 135 appears on a remittance when the payer applies an adjustment for interim bills cannot be processed. Review the group code and any accompanying RARC codes to understand the full context of this adjustment.

Common scenarios that trigger this adjustment include: the payer does not process interim or split bills and requires a single claim for the entire episode of care; The bill type submitted indicates an interim bill, but the payer's system does not support interim billing for this service type; An interim bill for a long-stay inpatient was submitted before the payer's required billing cycle date. The group code paired with CARC 135 determines who bears the financial responsibility — CO places it on the provider as a contractual obligation, OA indicates a coordination of benefits or other payer adjustment, PR shifts it to the patient.

How to Resolve

1. Review the adjustment Examine the PR-135 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.

How to Prevent PR-135

• Verify patient benefits and financial responsibility before rendering services
• Communicate potential out-of-pocket costs to patients proactively

Also Filed As

The same CARC 135 may appear with different Group Codes:

Related Denial Codes