Health insurance denial & claim adjustment codes
The plan says a step in its own required process was not followed before the service or the claim. Procedural denials of this kind can often be cured, because they say nothing about whether the care itself was appropriate.
Ask which specific procedure was missed. Procedural defects are usually curable without touching the merits.
Check if this denial is worth appealing
Check if this denial is worth appealing → Free. No account, no card.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.