PR-192: Non-Standard Adjustment Code from Paper Remittance

What Does PR-192 Mean?

With PR (Patient Responsibility), the non-standard paper adjustment may include a patient responsibility component (such as a deductible or coinsurance) that was not properly mapped. Review the paper EOB to determine the patient's actual obligation.

CARC 192 is a technical code used in coordination of benefits (COB) transactions when the primary payer issued a paper remittance (not an electronic ERA) and the adjustment reason on that paper EOB cannot be reasonably mapped to an existing standard CARC. This code serves as a catch-all placeholder in the 837 COB transaction.

This code is not a clinical or coverage denial — it is an administrative artifact of converting paper remittance information into electronic format. The actual adjustment reason from the primary payer is on the paper EOB, and the secondary payer or billing team needs to review that original document to understand the real reason for the adjustment.

How to Resolve

1. Review the paper EOB for patient responsibility Check the primary payer's paper EOB to identify any deductible, coinsurance, or copayment amounts assigned to the patient.
2. Map and resubmit correctly Map the patient responsibility amounts to the correct CARC codes and resubmit the COB transaction.

How to Prevent PR-192

• Review paper EOBs carefully for all adjustment types including patient responsibility before submitting COB transactions

Also Filed As

The same CARC 192 may appear with different Group Codes:

Related Denial Codes