OA-282: Procedure/Revenue Code Does Not Match Type of Bill

What Does OA-282 Mean?

When paired with Group Code OA, CARC 282 typically appears in a secondary payer or coordination of benefits context. The adjustment for procedure/revenue code does not match type of bill is being processed through COB rules. The financial responsibility depends on the specific coordination arrangement between payers.

CARC 282 indicates a technical billing error where the procedure or revenue code submitted on the claim is inconsistent with the type of bill (TOB). This is a structural mismatch — certain codes are only valid with specific bill types, and the payer's system flagged the inconsistency during claim processing.

Common examples include billing an outpatient procedure code on an inpatient bill type, using a revenue code that is not valid for the submitted bill type classification (inpatient, outpatient, SNF, home health, etc.), or selecting the wrong type of bill in the billing system altogether. These errors are typically data entry mistakes or billing system configuration issues rather than clinical documentation problems.

The 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF) often provides additional detail about which specific code triggered the inconsistency. This code is a straightforward billing correction — fix the mismatch and resubmit. Appeals are not appropriate because this is a correctable coding error.

How to Resolve

1. Review the coordination of benefits Examine the OA-282 adjustment and determine how it fits within the primary/secondary payer relationship.
2. Verify primary payer adjudication Review the primary payer's EOB to understand the basis for the secondary payer's OA adjustment.
3. Determine appropriate action Based on the COB review, decide whether to accept the adjustment, submit additional documentation, or file an appeal with the secondary payer.
4. Follow up Monitor the claim and take additional action as needed based on the COB determination.

How to Prevent OA-282

• Maintain current coordination of benefits information for patients with multiple insurance plans
• Submit complete documentation including primary payer EOBs when filing secondary claims
• Verify secondary payer requirements before claim submission
• Track OA adjustment patterns to identify systemic COB issues

Also Filed As

The same CARC 282 may appear with different Group Codes:

Related Denial Codes