OA-267: Claim/Service Spans Multiple Months

What Does OA-267 Mean?

OA-267 may appear when the multi-month claim involves coordination between payers or when the payer applies the adjustment outside standard contractual categories. The same resolution applies — correct the claim format and resubmit.

When CARC 267 appears on a remittance, the payer is flagging that the dates of service on your claim cross from one calendar month into another — and the claim does not include the required remark code to accompany a multi-month service. This is a technical formatting denial, not a clinical or coverage issue. The payer's adjudication system requires either a specific remark code (NCPDP Reject Reason Code or a non-ALERT Remittance Advice Remark Code) on multi-month claims, or it requires you to split the claim into separate monthly submissions.

This code surfaces most frequently with long-term care facilities, home health agencies, behavioral health providers, and any practice that bills for services spanning weeks or months — such as rental DME, ongoing therapy courses, or residential treatment programs. The root cause is almost always a billing system configuration issue: the system either failed to attach the required remark code or did not automatically split the claim at month boundaries.

The resolution is straightforward but varies by payer. Some payers accept multi-month claims when accompanied by the proper remark code. Others require one claim per calendar month regardless. Check the specific payer's billing guidelines to determine which approach to take, then correct and resubmit. No appeal is necessary since this is a formatting requirement, not a coverage dispute.

How to Resolve

1. Determine if the adjustment involves payer coordination Check whether the OA-267 adjustment is related to coordination of benefits or a secondary payer routing issue.
2. Correct and resubmit Add the required remark code or split the claim by month. If a secondary payer is involved, submit to the next payer with the primary remittance.

How to Prevent OA-267

• Verify insurance coordination details at intake to ensure multi-month claims are routed to the correct primary payer
• Apply the same monthly claim splitting rules regardless of payer type

Also Filed As

The same CARC 267 may appear with different Group Codes:

Related Denial Codes