CO-148: Information from Another Provider Not Provided or Incomplete
Provider responsibility — correct the issue and resubmit the claim. The patient is not liable for this amount.
What Does CO-148 Mean?
With CO (Contractual Obligation), the CARC 148 adjustment is the provider's responsibility. The payer denied or reduced payment because of the referring provider did not submit the required referral documentation or authorization number, and the payer cannot process the claim without it. The patient is not liable for this amount.
CARC 148 is used when the payer determines that information from another provider not provided or incomplete. The claim could not be processed as submitted because required information was absent, incomplete, or did not meet the payer's submission standards.
Common scenarios that trigger this adjustment include: the referring provider did not submit the required referral documentation or authorization number, and the payer cannot process the claim without it; Information from the primary insurance provider needed for coordination of benefits was not included or was incomplete on the claim submission; The payer requires clinical documentation from another treating provider (such as an operative report from a surgeon when billing for assistant services) that was not submitted. The group code paired with CARC 148 determines who bears the financial responsibility — CO places it on the provider as a contractual obligation, OA indicates a coordination of benefits or other payer adjustment, PR shifts it to the patient.
Common Causes
| Cause | Frequency |
|---|---|
| Missing referral or authorization information from referring provider The referring provider did not submit the required referral documentation or authorization number, and the payer cannot process the claim without it | Most Common |
| Incomplete coordination of benefits information from primary payer Information from the primary insurance provider needed for coordination of benefits was not included or was incomplete on the claim submission | Most Common |
| Missing operative report or clinical notes from another provider The payer requires clinical documentation from another treating provider (such as an operative report from a surgeon when billing for assistant services) that was not submitted | Common |
| Incomplete prior treatment records The claim requires documentation of prior treatment from another provider to establish medical necessity, but this information was not provided | Common |
| Missing lab or diagnostic results from external facility Lab results or diagnostic imaging reports from an external facility that are required to support the billed service were not submitted with the claim | Occasional |
How to Resolve
- Review the remittance details Examine the CO-148 adjustment and any accompanying RARC codes to identify the specific reason for the denial.
- Identify the root cause Determine which issue applies: missing referral or authorization information from referring provider, incomplete coordination of benefits information from primary payer, missing operative report or clinical notes from another provider, among others.
- Correct the claim Address the identified issue — update the claim data in your billing system to resolve the information from another provider not provided or incomplete problem.
- Resubmit the corrected claim Submit the corrected claim following the payer's resubmission guidelines. Include any supporting documentation that addresses the denial reason.
This denial indicates information from another provider was missing or incomplete. Obtain the required information from the other provider and resubmit the claim rather than appealing.
Common RARC Pairings
The RARC code tells you exactly what triggered the CO-148:
| RARC | Description |
|---|---|
| N130 | You may need to review plan documents or guidelines Review payer guidelines to identify exactly which information from another provider is required → |
| MA04 | Secondary payment cannot be considered without the identity of or payment information from the primary payer Obtain and submit the primary payer's EOB or payment information before resubmitting → |
How to Prevent CO-148
- Establish workflows to collect all required documentation from referring and treating providers before claim submission
- Verify coordination of benefits information is complete before submitting claims to secondary payers
- Implement checklists for claims that require information from external providers to ensure completeness
- Use electronic health information exchange when available to obtain records from other providers efficiently
- Follow up promptly with referring providers for outstanding documentation to avoid submission delays
- Train billing staff to identify claims that require external provider information and verify completeness before submission
Also Filed As
The same CARC 148 may appear with different Group Codes: