OA-135: Interim Bills Cannot Be Processed
Adjustment in a COB or secondary payer context. Review the coordination of benefits details to determine the responsible party.
What Does OA-135 Mean?
When paired with Group Code OA, CARC 135 (Interim Bills Cannot Be Processed) 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 135 appears on a remittance when the payer applies an adjustment for interim bills cannot be processed. 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 payer does not process interim or split bills and requires a single claim for the entire episode of care; The bill type submitted indicates an interim bill, but the payer's system does not support interim billing for this service type; An interim bill for a long-stay inpatient was submitted before the payer's required billing cycle date. The group code paired with CARC 135 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
- Review the coordination of benefits Examine the OA-135 adjustment to understand how it fits within the primary/secondary payer relationship or other multi-payer context.
- Verify primary payer adjudication Review the primary payer's EOB to understand the basis for the secondary payer's OA adjustment.
- 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.
- 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.
- Follow up Monitor the claim status and take additional action as needed based on the COB determination.
This is a billing format issue — interim bills are not accepted by this payer. Submit a final bill for the complete episode of care instead.
How to Prevent OA-135
- Maintain accurate coordination of benefits information
- Verify secondary payer requirements before claim submission
Also Filed As
The same CARC 135 may appear with different Group Codes:
Related Denial Codes
Sources
- https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps
- https://www.aapc.com/resources/claim-adjustment-reason-code-carc
- https://www.mdclarity.com/denial-code/135
- Codes maintained by X12. Visit x12.org for official definitions.