OakClaim
PR-66Patient ResponsibilityPatient Responsibility

PR-66 Denial Code: Blood deductible

The patient's blood deductible applies (Medicare's first-3-pints rule) — the amount is patient responsibility unless replaced.

Why PR-66 happens

  • First three units of blood in a benefit period aren't covered by Medicare

How to fix a PR-66 denial

  1. 1

    Post to patient responsibility; note replacement credits if the patient/donors replaced units

How to prevent it

Educate patients receiving transfusions about the blood deductible up front.

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