CARC 146 Active

OA-146: Diagnosis Invalid for Date of Service

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-146 Mean?

When paired with Group Code OA, CARC 146 (Diagnosis Invalid for Date of Service) 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 146 appears on a remittance when the payer identifies an issue related to diagnosis invalid for date of service. This is a technical billing or coding problem that must be corrected before the claim can be processed for payment. The denial indicates the claim data did not meet the payer's adjudication requirements.

Common scenarios that trigger this adjustment include: the diagnosis code used on the claim was valid at one point but has been retired or replaced with a newer code effective before the date of service; The diagnosis code used on the claim has a future effective date and was not valid on the date the service was rendered; The ICD-10 code lacks required specificity digits — the code was submitted without the necessary 4th, 5th, 6th, or 7th character required for the date of service. The group code paired with CARC 146 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-146 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.
Do Not Appeal This Code

This denial indicates the diagnosis code was invalid for the date of service. Correct the diagnosis code to one that was active on the service date and resubmit the claim rather than appealing.

How to Prevent OA-146

Also Filed As

The same CARC 146 may appear with different Group Codes:

CO-146 PR-146

Related Denial Codes

OA-16 — Missing Information or Billing Error OA-148 — Information from Another Provider Not Provided or Incomplete OA-175 — Prescription Is Incomplete OA-181 — Procedure Code Invalid on Date of Service OA-206 — National Provider Identifier - Missing

Sources

  1. https://www.mdclarity.com/denial-code/146
  2. https://myfcbilling.com/denial-code-146-diagnosis-invalid-for-the-date-of-service/
  3. https://x12.org/codes/claim-adjustment-reason-codes
  4. https://medicaid-documents.dhhs.utah.gov/Documents/pdfs/ClaimDenialCodes.pdf
  5. Codes maintained by X12. Visit x12.org for official definitions.