OA-P2: Non-Work Related Injury/Illness

What Does OA-P2 Mean?

OA-P2 signals that the WC carrier has determined the injury is not work-related and the claim should be redirected to another payer. Unlike CO, the OA group code indicates this is not strictly a contractual write-off — it is an informational adjustment directing the provider to rebill the appropriate insurer. The provider should identify the correct payer and resubmit.

When CARC P2 appears on a workers' compensation remittance, the carrier is telling you that it has investigated the claim and concluded that the injury or illness did not arise out of or in the course of the patient's employment. Because the condition is not work-related, the WC carrier has no liability for the services. This code replaces the older CARC 191 and is restricted exclusively to workers' compensation claims.

P2 most commonly appears with Group Code CO, which means the carrier is treating the denial as a contractual obligation — you cannot bill the patient for the WC-denied amount. Instead, you need to redirect the claim to the correct payer. In many cases, the patient has group health insurance or other coverage that will cover the treatment once it is properly billed outside the WC context. If you have evidence that the injury is genuinely work-related, you can challenge the carrier's compensability determination through the WC administrative dispute process.

The key distinction with P2 is that the carrier is not saying the services were medically unnecessary or improperly coded — it is saying the WC carrier is simply not the responsible payer. This means the services may be fully payable by another insurer. Providers who treat WC patients should always collect alternate insurance information at intake as a fallback against exactly this scenario.

Common Causes

How to Resolve

Verify the non-work-related determination, then either dispute it or rebill to the patient's alternate insurance.

1. Identify the correct payer Review the patient's insurance information to identify their group health plan, auto insurance, or other coverage that should receive the claim now that WC has denied liability.
2. Resubmit to the appropriate payer Prepare and submit the claim to the identified payer using the correct payer ID, policy number, and any required documentation for non-WC claims.
3. Update billing records Flag the WC claim as denied/redirected and ensure future claims for this condition are routed to the correct payer from the start.

How to Prevent OA-P2

• Always collect alternate insurance information at patient intake for WC cases
• Set up billing workflows that automatically flag WC-denied claims for rebilling to alternate coverage
• Verify WC eligibility before every visit to catch compensability changes early

General Prevention

• Collect the patient's group health insurance information at intake as a fallback if the WC claim is denied
• Verify workers' compensation eligibility before rendering services to avoid billing the wrong payer
• Set up billing workflows that flag WC claims for automatic rebilling to alternate coverage when denied as non-work-related

Also Filed As

The same CARC P2 may appear with different Group Codes:

Related Denial Codes