CARC 235 Active

OA-235: Sales Tax

TL;DR

Sales tax was adjusted during COB. Verify the tax treatment.

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-235 Mean?

With OA, the sales tax adjustment appeared during coordination of benefits.

CARC 235 indicates a sales tax component on the claim. Some states impose sales tax on medical products, equipment, or supplies, and this code reflects the tax adjustment in the claim processing. The payer may be adding, adjusting, or denying the sales tax component depending on the jurisdiction and the specific product billed.

Sales tax rules vary significantly by state — some states exempt medical devices and prescription drugs from sales tax, while others impose tax on DME, medical supplies, or over-the-counter products. The treatment of sales tax on insurance claims depends on both state law and the payer's policy.

Common Causes

Cause Frequency
Informational sales tax adjustment Sales tax is reported as an OA informational adjustment Common

How to Resolve

  1. Verify the tax Confirm the sales tax is correct.
  2. Accept or contest Accept if correct, or contest if misapplied.
Do Not Appeal This Code

This is a standard sales tax adjustment. No appeal is warranted.

How to Prevent OA-235

General Prevention

Also Filed As

The same CARC 235 may appear with different Group Codes:

Related Denial Codes

Sources

  1. https://x12.org/codes/claim-adjustment-reason-codes
  2. 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
  3. https://www.aapc.com/resources/claim-adjustment-reason-codes
  4. Codes maintained by X12. Visit x12.org for official definitions.