OA-175: Prescription Is Incomplete

What Does OA-175 Mean?

With OA (Other Adjustments), the incomplete prescription surfaced during coordination of benefits processing. This typically occurs when a secondary payer identifies the prescription deficiency while processing its portion of the claim. The adjustment signals that the prescription issue must be resolved before any payer in the COB chain can complete processing.

CARC 175 indicates that the prescription or physician order associated with the claim does not contain all the elements the payer requires for processing. This could mean the prescription is missing a diagnosis, dosage, frequency, duration, prescriber signature, date, or other mandatory components.

This code appears most frequently on claims for durable medical equipment (DME), home health services, and pharmacy items where detailed physician orders are required. The payer cannot adjudicate the claim until a fully complete prescription is on file. This is not a coverage denial — it signals that the documentation supporting the claim needs to be corrected before the payer will process payment.

How to Resolve

1. Review the COB remittance details Examine the remittance from each payer in the coordination chain to determine which payer flagged the incomplete prescription.
2. Obtain the complete prescription Get a fully completed prescription from the ordering physician that satisfies all payer requirements.
3. Resubmit to the appropriate payer Submit the corrected claim with the complete prescription to the payer that identified the issue, following the correct COB submission order.
4. Follow up across payers Once the primary payer processes the corrected claim, submit the EOB to the secondary payer for processing.

How to Prevent OA-175

• Ensure prescriptions meet the requirements of all payers in the coordination of benefits chain before initial submission
• Verify prescription completeness requirements for both primary and secondary payers
• Submit complete documentation with the initial claim to prevent delays in multi-payer processing

Also Filed As

The same CARC 175 may appear with different Group Codes:

Related Denial Codes