Skip to main content

CO-192 Code: Non-Standard Paper Remittance Adjustment

CO-192 is a coordination of benefits code. It lets a provider or payer pass a non-standard adjustment from a paper remittance to another payer on an 837 claim, when that adjustment can't reasonably be mapped to a standard CARC. It isn't a denial reason on its own.

Quick facts

Code
CO-192 (CARC 192)
Status
Active In use since October 31, 2005; last modified July 1, 2017.
Code set
Claim Adjustment Reason Codes (CARC)
Group codes
  • CO (Contractual Obligation): The prior payer's non-standard adjustment was a contractual reduction the provider absorbs.
  • PR (Patient Responsibility): The non-standard amount represented patient responsibility on the prior payer's paper remittance.
  • OA (Other Adjustment): The adjustment is reported as other, without assigning responsibility.
Official description
Non standard adjustment code from paper remittance. Usage: This code is to be used by providers/payers providing Coordination of Benefits information to another payer in the 837 transaction only. This code is only used when the non-standard code cannot be reasonably mapped to an existing Claims Adjustment Reason Code, specifically Deductible, Coinsurance and Co-payment.
X12 Claim Adjustment Reason Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What CO-192 means

CARC 192 reads “Non standard adjustment code from paper remittance.” Its usage note is narrow: it’s for providers and payers giving coordination of benefits (COB) information to another payer in the 837 claim, and only when a non-standard code from a paper remittance can’t reasonably be mapped to an existing CARC. The note specifically calls out deductible, coinsurance, and copayment as amounts that must be mapped to their standard codes instead.

In practice, this matters when the primary payer only issues paper EOBs with proprietary codes, and you need to send an electronic secondary claim. Each primary adjustment must be reported in the 837’s CAS segments, and 192 is the fallback for the ones with no standard equivalent.

Example: a primary payer’s paper EOB shows a reduction labeled with its own internal code that doesn’t correspond to any CARC. The billing team reports the patient’s coinsurance as CARC 2, the contractual reduction as CARC 45, and the one unclear amount as CARC 192 on the secondary claim.

When CO-192 causes problems

  • Overuse: mapping everything to 192, including deductible and coinsurance, can cause the secondary payer to miscalculate or deny.
  • Balancing errors: the 837 COB amounts must balance. Wrong amounts in the CAS segments can cause rejections.
  • Missing primary EOB: the secondary payer may need the paper remittance to interpret the adjustment.

How to handle it

  1. Map every primary adjustment to the closest standard CARC first, especially deductible (1), coinsurance (2), and copay (3).
  2. Use CARC 192 only for amounts that genuinely have no standard equivalent, with the group code that fits.
  3. Check that the claim balances: billed charges minus adjustments equal the primary paid amount.
  4. Keep the paper EOB on file and send it if the secondary payer requests it.
  5. If the secondary payer denies or questions the COB data, submit the primary EOB and a corrected claim if needed.

How to prevent problems

  • Build a crosswalk from each paper-EOB payer’s proprietary codes to CARCs.
  • Encourage primary payers to send ERAs where possible, avoiding manual mapping.
  • Review secondary claims for COB balancing before submission. See eligibility and COB root causes.
  • OA-23 (The impact of prior payer(s) adjudication including payments and/or adjustments. (Use only with Group Code OA)): The impact of prior payer adjudication, used by the secondary payer on its own remittance.
  • OA-22 (This care may be covered by another payer per coordination of benefits.): The care may be covered by another payer under coordination of benefits.
  • PR-1 / PR-2 / PR-3 (Deductible, coinsurance, and co-payment amounts.): Standard cost-sharing codes. The usage note says to map to these, not CARC 192, when the paper amount is one of them.

CO-192 FAQ

When should I use CARC 192 on a secondary claim?

Only when the primary payer sent a paper EOB with its own non-standard reason code and you can't reasonably translate it to an existing CARC. Deductible, coinsurance, and copay amounts should always be mapped to CARCs 1, 2, and 3.

Why would I see CO-192 on an ERA?

It's intended for 837 COB reporting. If a payer returns it on an ERA, it's likely echoing data from a prior payer. Contact the payer if the amount is unclear.

Does a secondary payer accept CARC 192?

Payers vary. Some accept it; others may ask for the primary EOB to understand the adjustment. Keep the paper EOB available.

Is CARC 192 something to appeal?

Usually not. It's a reporting code for COB data, not a payer decision. If a secondary payer mishandled the amount, fix the COB data or send the primary EOB rather than filing an appeal.