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PR-127 Denial Code (Deactivated): Major Medical Coinsurance

PR-127 reported coinsurance owed under a major medical benefit. X12 deactivated it and its notes tell payers to use Group Code PR with CARC 2 instead.

X12 deactivated CARC127 on April 1, 2008. Payers should no longer use it on new remittances, but it can still appear on older ERAs, corrected claims, and appeals.

Code: PR-127 (CARC 127)
Status: Deactivated StoppedApril 1, 2008 (in use since February 28, 1997).
Code set: Claim Adjustment Reason Codes (CARC)
Group codes: PR (Patient Responsibility): Coinsurance is patient cost-sharing, so the amount belonged to the patient.
Official description: Coinsurance -- Major Medical
X12 Claim Adjustment Reason Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What PR-127 meant

CARC 127 was the coinsurance counterpart of code 126. Under plan designs that included a major medical layer, the member might owe a percentage of the allowed amount specifically under that layer. This code carried that percentage share on the remittance. The money was owed by the patient, so it appeared with the PR group.

What replaced it

X12’s note says to use Group Code PR and code 2. PR-2 is therefore the replacement, reporting coinsurance without distinguishing benefit layers. Major medical adjustments that are not coinsurance still have CO-102, and deductibles are PR-1.

If you still see PR-127

It only exists in legacy remittances. Treat it as patient coinsurance: transfer the amount to the patient or to a secondary plan if one exists. Should a remittance ever show it with a CO group, ask the payer to clarify before sending the patient a statement, because the group code controls who is liable.

PR-2 (Coinsurance Amount): Named replacement when used with group PR: coinsurance amount.
CO-102 (Major Medical Adjustment.): Major medical adjustment, which is still active.
PR-1 (Deductible Amount): Deductible amount, usually applied before coinsurance.

PR-127 FAQ

Is PR-127 the same as PR-2?

For practical purposes, yes. X12 retired 127 and pointed to code 2 with the PR group, which reports coinsurance from any benefit layer.

Why did a separate major medical coinsurance code exist?

Plans with a base benefit and a major medical benefit could apply different coinsurance percentages to each layer. The separate code let payers show which layer produced the charge.

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