CARC 22OA · Other Adjustment
The payer believes another insurance plan should be billed first or is otherwise responsible under coordination-of-benefits rules.
- Common causes
- The payer's records show the patient has other active coverage, or the coordination-of-benefits information on file is outdated.
- Suggested fix
- Confirm the patient's current coverage order, update coordination-of-benefits information with the payer if needed, and bill the correct primary payer first.
Related Other Adjustment codes
109This payer isn't responsible for this claim; it needs to be sent to a different payer or contractor.136The claim wasn't processed correctly because it didn't follow the rules or requirements set by a prior (primary) payer.140The member ID number submitted doesn't match the patient or subscriber name on file with the payer.18This claim or service line is an exact duplicate of one already submitted and processed.19The payer has determined this claim relates to a work injury or illness, making workers' compensation the responsible party instead.215Payment was adjusted based on a third-party settlement where the payer has subrogation rights to recover costs.23This adjustment reflects how a prior payer already processed the claim, reducing what this payer pays as a result.253Payment was reduced due to mandatory federal budget sequestration, a government-wide across-the-board cut applied to Medicare payments.
Frequently asked questions
What does CARC 22 mean?
The payer believes another insurance plan should be billed first or is otherwise responsible under coordination-of-benefits rules.
How do I resolve CARC 22?
Confirm the patient's current coverage order, update coordination-of-benefits information with the payer if needed, and bill the correct primary payer first.
Why does CARC 22 happen?
The payer's records show the patient has other active coverage, or the coordination-of-benefits information on file is outdated.
CARC codes maintained by X12 (x12.org). Descriptions on this site are original reference interpretations. Always verify codes with authoritative sources before making billing decisions.