Wiki Denial Code

[GENOWAL]

I am starting to see denial code PIB22. Has anyone dealt with this before? Is this a write off, are you appealing the denial or billing the patient? Any help offered is great! Thank you

 

[thomas7331]

If the payer is following standard denial codes, PI indicates 'payer initiated reduction' and B22 is 'payment is adjusted based on the diagnosis'. These codes, by themselves, don't give enough information as to whether or not this would be a write-off, patient responsibility, or if it can be appealed. You would need to know your payer's rules and your provider's contractual obligations under the particular plan in order to make this determination.