PR 247 denial code

Claim adjustment reason code 247. Often reported as PR 247.

Facility-billed professional deductible

Unofficial reference. This is our own plain-English explanation, not the official code text. Payer rules differ. Verify with the payer and the official X12 code list. AlphaPrefix is not affiliated with X12, CMS or any payer. Data last updated Nov 11, 2026.

What 247 means

This is the deductible on a professional service that was given in an institutional setting and billed on the facility claim.

Some arrangements put the professional part of the care on the facility's institutional claim instead of a separate professional claim. The code separates the deductible on the professional part from the facility part.

It works like an ordinary deductible: it is the patient's share, often billed to a secondary payer if one exists.

Group codes seen with 247

On a remittance, 247 comes after a group code. These are the ones it is most often reported with:

• PR 247 (Patient Responsibility): The amount is assigned to the patient. Deductibles, coinsurance and copays are the everyday examples. Whether you can collect it still depends on your contract and the patient's plan.

The payer chooses the group code for each adjustment, so the same reason code can appear with another group code on your remittance. Read the two together. More about group codes.

Common causes

• The patient had not met their deductible when the bundled service was billed.
• A professional service was billed on the institutional claim under a bundled payment model.
• The facility participates in a bundled payment arrangement that uses this split.

What to do next

1. Confirm the amount matches the patient's remaining deductible.
2. Bill any secondary or supplemental payer with the remittance.
3. Follow your patient balance process for any amount left after secondary payment.

Related codes

• 248 (reason code) Facility-billed professional coinsurance
• 1 (reason code) Amount applied to the deductible
• 2 (reason code) Patient's coinsurance share