CARC 143 Active

OA-143: Portion of Payment Deferred

TL;DR

Adjustment in a COB or secondary payer context. Review the coordination of benefits details to determine the responsible party.

Action
Review & Decide
Who Pays
Depends
Appeal
No
Patient Impact
Indirect
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 OA-143 Mean?

When paired with Group Code OA, CARC 143 (Portion of Payment Deferred) 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 143 appears on a remittance when the payer applies an adjustment for portion of payment deferred. 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 has approved the claim but is withholding a portion of payment pending additional review, medical record request, or audit completion; Federal or state budget constraints require a portion of the payment to be deferred to a future payment cycle; The payer's contract or payment methodology includes a phased payment approach where a portion of the claim is paid initially and the remainder is deferred to a reconciliation period. The group code paired with CARC 143 determines who bears the financial responsibility — OA indicates a coordination of benefits or other payer adjustment, CO places it on the provider as a contractual obligation, PR shifts it to the patient.

Common Causes

Cause Frequency
Payment held pending additional review The payer has approved the claim but is withholding a portion of payment pending additional review, medical record request, or audit completion Most Common
Sequestration or budget-related payment delay Federal or state budget constraints require a portion of the payment to be deferred to a future payment cycle Common
Phased payment arrangement The payer's contract or payment methodology includes a phased payment approach where a portion of the claim is paid initially and the remainder is deferred to a reconciliation period Common
Risk-sharing arrangement holdback Under a risk-sharing or value-based payment arrangement, a portion of payment is deferred pending performance metric evaluation Common
Cash flow management by payer The payer defers a portion of payment due to cash flow or processing reasons, with the remainder to be issued in a subsequent payment cycle Occasional

How to Resolve

  1. Review the coordination of benefits Examine the OA-143 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. Follow up Monitor the claim status and take additional action as needed based on the COB determination.
Do Not Appeal This Code

This is a payment deferral, not a denial. The deferred portion will be released in a future payment cycle or when any pending requirements are met. Track the deferred amount and follow up with the payer.

Common RARC Pairings

The RARC code tells you exactly what triggered the OA-143:

RARC Description
N381 A portion of the payment has been deferred pending further review or a future payment cycle Track the deferred amount and follow up with the payer on the expected payment date →
N283 Additional information may be needed before the deferred portion can be released Submit any requested documentation to expedite release of the deferred payment →

How to Prevent OA-143

Also Filed As

The same CARC 143 may appear with different Group Codes:

CO-143 PR-143

Related Denial Codes

OA-133 — Service Line Pending Further Review OA-100 — Payment Made to Patient/Insured OA-105 — Tax Withholding Amount OA-121 — Indemnification Adjustment OA-136 — Failure to Follow Prior Payer's Coverage Rules

Sources

  1. https://www.cms.gov/medicare/claims-appeals/organization-determinations
  2. https://www.aapc.com/resources/claim-adjustment-reason-code-carc
  3. https://www.mdclarity.com/denial-code/143
  4. Codes maintained by X12. Visit x12.org for official definitions.