CO-192: Non-Standard COB Adjustment Code
The COB adjustment is a contractual write-off. Review the payer contract to understand the adjustment basis and determine if the secondary payer covers any remaining balance.
What Does CO-192 Mean?
CO-192 is less common and may appear when the non-standard COB adjustment represents a contractual write-off, such as when the primary payer's contract includes a provision that results in an adjustment the provider must absorb.
CARC 192 appears on your remittance when a payer uses a non-standard adjustment to communicate Coordination of Benefits information, typically in 837 transactions between payers. This code is specifically designed for situations where the primary payer made an adjustment that cannot be mapped to an existing standard CARC code for deductible, coinsurance, or co-payment — essentially a catch-all for COB adjustments that do not fit the normal categories.
This code behaves differently from most CARC codes because it is fundamentally informational rather than actionable. The primary payer is telling you (or the secondary payer) about an adjustment, but the adjustment itself may not represent a denial or a problem to fix. In practice, you will most commonly see CARC 192 when processing secondary claims — the primary payer's ERA includes this code to convey adjustment amounts that the secondary payer needs to know about for proper benefit coordination.
The key challenge with CARC 192 is interpretation. Because it is a non-standard catch-all, the specific meaning varies by payer. One payer may use it for a premium surcharge adjustment while another uses it for a plan-specific limitation that has no standard code equivalent. The ERA's accompanying RARC codes and any additional notes from the payer are critical for understanding what the adjustment actually represents and how to bill the secondary payer correctly.
How to Resolve
Review the primary payer's EOB for COB adjustment details, determine the correct secondary billing amount, and submit the secondary claim with accurate COB information.
- Review the payer contract Check the provider's contract with the primary payer to understand what type of adjustment code 192 represents under CO designation.
- Bill the secondary payer Determine if any remaining balance is billable to the secondary payer and submit with the primary payer's EOB.
How to Prevent CO-192
- Understand each payer's specific use of code 192 under different group code designations
- Document contract provisions that may result in non-standard adjustments
Also Filed As
The same CARC 192 may appear with different Group Codes:
Related Denial Codes
Sources
- https://www.mdclarity.com/denial-code/192
- https://denialcode.com/
- Codes maintained by X12. Visit x12.org for official definitions.