OA-232: Institutional Transfer Amount
The transfer adjustment was applied during COB. Verify and appeal if incorrect.
What Does OA-232 Mean?
With OA, the transfer adjustment appeared during coordination of benefits.
CARC 232 is specific to inpatient institutional claims where the patient was transferred from one facility to another during the inpatient stay. Under Medicare's transfer policy, when a patient is transferred before the full episode of care is complete, the transferring hospital receives a per diem payment rather than the full DRG amount. The per diem rate is calculated based on the DRG payment divided by the geometric mean length of stay.
This adjustment ensures the transferring hospital is paid proportionally for the portion of the inpatient stay they provided, rather than receiving the full DRG payment for an incomplete stay.
Common Causes
| Cause | Frequency |
|---|---|
| Transfer amount adjustment in coordination of benefits The transfer amount is adjusted in a multi-payer scenario | Common |
How to Resolve
- Verify the transfer classification Confirm the discharge qualifies as a transfer.
- Appeal if incorrect Submit documentation if the transfer was misclassified.
Appeal with documentation if the transfer amount calculation was incorrect.
How to Prevent OA-232
- Verify transfer classifications for all payers
General Prevention
- Verify transfer policies across all payers
Also Filed As
The same CARC 232 may appear with different Group Codes:
Related Denial Codes
Sources
- https://x12.org/codes/claim-adjustment-reason-codes
- https://portal.ct.gov/-/media/ohs/health-it-advisory-council/apcd-advisory-group/data-submission-guide-workgroup/meeting-materials/6-30-22/carc-codes_final.pdf
- https://www.aapc.com/resources/claim-adjustment-reason-codes
- Codes maintained by X12. Visit x12.org for official definitions.