Dentovio public answer

PR 96 denial code dental

On a dental remittance, code PR 96 means: The charge is not covered — the service falls outside the plan's benefits; a remark code must state the specific reason. structural: appeal rarely changes it. If the plan genuinely excludes the service, no appeal changes the contract — the productive moves are pre-treatment verification and patient financial conversations. Worth a second look only when the exclusion was misapplied (for example, a missing-tooth clause applied to a tooth extracted during coverage) — that narrow case is winnable with records.