CARC 192 Active

CO-192: Non-Standard Adjustment Code from Paper Remittance

TL;DR

Review the primary payer's paper EOB, map the adjustment to the correct standard code, and resubmit. Do not appeal.

Action
Verify & Resubmit
Who Pays
Provider
Appeal
No
Patient Impact
None
Disclaimer
This content is for informational purposes only and does not constitute professional billing advice. Always verify information against your payer contracts and current coding guidelines. Consult a certified billing specialist for specific claim issues.

What Does CO-192 Mean?

With CO (Contractual Obligation), the non-standard paper adjustment is treated as a contractual matter. The provider needs to review the primary payer's paper EOB, correctly map the adjustment, and resubmit. This is a data mapping issue, not a coverage denial.

CARC 192 is a technical code used in coordination of benefits (COB) transactions when the primary payer issued a paper remittance (not an electronic ERA) and the adjustment reason on that paper EOB cannot be reasonably mapped to an existing standard CARC. This code serves as a catch-all placeholder in the 837 COB transaction.

This code is not a clinical or coverage denial — it is an administrative artifact of converting paper remittance information into electronic format. The actual adjustment reason from the primary payer is on the paper EOB, and the secondary payer or billing team needs to review that original document to understand the real reason for the adjustment.

Common Causes

Cause Frequency
Paper remittance code cannot be mapped to standard CARC The primary payer used a non-standard adjustment code on a paper remittance that cannot be reasonably mapped to an existing standard Claim Adjustment Reason Code Most Common
Coordination of benefits data from non-electronic primary payer The primary payer does not issue electronic remittances, and the adjustment reason from the paper EOB was converted using this catch-all code for the 837 COB transaction Most Common
Deductible, coinsurance, or copayment amount from paper EOB The specific deductible, coinsurance, or copayment amount from the paper remittance could not be mapped to standard CARC codes like 1, 2, or 3 Common

How to Resolve

  1. Review the paper EOB Examine the primary payer's paper remittance to understand the actual adjustment reason.
  2. Map to the correct CARC Determine which standard CARC corresponds to the adjustment.
  3. Resubmit with the correct code Submit the corrected COB transaction with the proper standard code.
Do Not Appeal This Code

This code is used for paper remittance conversion in COB transactions. Review the primary payer's paper EOB to correctly map the adjustment to a standard CARC and resubmit.

Common RARC Pairings

The RARC code tells you exactly what triggered the CO-192:

RARC Description
N130 You may need to review plan documents or guidelines Review the primary payer's EOB to understand the original adjustment and properly map it →

How to Prevent CO-192

Also Filed As

The same CARC 192 may appear with different Group Codes:

OA-192 PR-192

Related Denial Codes

CO-147 — Provider Accepted Reduced Payment from Regulatory Authority CO-155 — Patient Refused the Service/Procedure CO-193 — Original Payment Decision Maintained on Review CO-216 — Based on Findings of a Review Organization CO-A0 — Patient Refund Amount

Sources

  1. https://www.mdclarity.com/denial-code-carcs
  2. https://x12.org/codes/claim-adjustment-reason-codes
  3. https://portal.ct.gov/-/media/ohs/health-it-advisory-council/apcd-advisory-group/data-submission-guide-workgroup/meeting-materials/6-30-22/carc-codes_final.pdf
  4. https://docs.claim.md/docs/claim-adjustment-reason-codes
  5. Codes maintained by X12. Visit x12.org for official definitions.