Health insurance denial & claim adjustment codes

What health insurance denial code 249 means on your EOB

A readmission penalty. Aimed at the hospital, but it can surface on your statement.

What usually causes it

• The admission fell within the readmission window.
• It was related to the prior admission.
• The penalty applies to the facility.

The documents that decide it

• The two admission dates.
• The EOB.
• Any bill you received.

What to do next

This is a payment adjustment against the hospital, not a patient charge. Verify before paying.

This page explains what a code means. It is information, not advice — it does not tell you whether your specific claim should have been paid, and it is not legal, medical, or insurance advice. Your plan documents and your denial notice govern your situation.