OA-132: Prearranged Demonstration Project Adjustment

What Does OA-132 Mean?

When paired with Group Code OA, CARC 132 (Prearranged Demonstration Project Adjustment) is processed as an adjustment outside the standard CO/PR classifications. This typically occurs in secondary payer or coordination of benefits scenarios. Review the remittance details and the COB arrangement to determine financial responsibility and appropriate next steps.

CARC 132 appears on a remittance when the payer applies an adjustment for prearranged demonstration project adjustment. Review the group code and any accompanying RARC codes to understand the full context of this adjustment.

Common scenarios that trigger this adjustment include: the provider participates in a CMS Innovation Center demonstration project, and CARC 132 reflects the adjusted payment per the project's specific payment methodology; Under a bundled payment demonstration, the payment is adjusted to reflect the episode-based payment rather than fee-for-service rates; The provider participates in a value-based payment demonstration, and the payment is adjusted based on quality and cost performance metrics. The group code paired with CARC 132 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.

How to Resolve

1. Review the coordination of benefits Examine the OA-132 adjustment to understand how it fits within the primary/secondary payer relationship or other multi-payer context.
2. Verify primary payer adjudication Review the primary payer's EOB to understand the basis for the secondary payer's OA adjustment.
3. Determine the responsible party Based on the COB review, identify whether the adjustment should be absorbed, billed to another payer, or if additional documentation is needed.
4. Appeal or resubmit if needed If the OA adjustment appears incorrect based on the COB arrangement, submit an appeal or corrected claim with the appropriate documentation.
5. Follow up Monitor the claim status and take additional action as needed based on the COB determination.

How to Prevent OA-132

• Maintain accurate coordination of benefits information
• Verify secondary payer requirements before claim submission

Also Filed As

The same CARC 132 may appear with different Group Codes:

Related Denial Codes