PR-29: Timely Filing Limit Expired

What Does PR-29 Mean?

With PR (Patient Responsibility), the CARC 29 adjustment for timely filing limit expired 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 29 indicates timely filing limit expired. The payer rejected the claim because it was not received within the required filing deadline specified by the payer's guidelines or the provider contract.

Common scenarios that trigger this adjustment include: provider failed to submit the claim within the payer's timely filing limit (typically 90 days to 1 year from date of service); Waiting for primary payer adjudication caused the secondary claim to miss the filing deadline; Original claim was denied and the corrected resubmission exceeded the timely filing limit. The group code paired with CARC 29 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-29 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-29

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

Also Filed As

The same CARC 29 may appear with different Group Codes:

Related Denial Codes