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CO-293 Denial Code: Payment Made to Employer

CO-293 means the payer issued payment for the claim or service to an employer instead of to the provider. The claim was paid, but not to you, so you need to collect from the employer or ask the payer why the payment was directed there.

Quick facts

Code
CO-293 (CARC 293)
Status
Active In use since May 1, 2018.
Code set
Claim Adjustment Reason Codes (CARC)
Group codes
  • CO (Contractual Obligation): The payer's usual group. The amount was paid elsewhere; it isn't new patient responsibility.
  • OA (Other Adjustment): Some payers use OA because the adjustment only reflects where the money went.
Official description
Payment made to employer.
X12 Claim Adjustment Reason Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What CO-293 means

CARC 293 says payment made to employer. The payer approved the claim but directed the payment to the patient’s employer instead of to the billing provider. On your remittance, the amount appears as an adjustment so the claim balances, even though you received nothing.

This code is informational in the sense that the payer isn’t disputing coverage. But financially it matters: until you collect from the employer, the balance is open.

Example: an employer sends an employee for a pre-placement exam and pays the clinic directly. The clinic also submits a claim to the employee’s health plan. The plan processes it and sends payment to the employer, which had already paid. The remittance shows CO-293, and the clinic needs to reconcile with the employer, not the patient.

Common causes

  • Employer-sponsored occupational services, such as pre-employment exams, drug screens, or on-site clinics.
  • Employer reimbursement arrangements, where the employer paid the provider and the plan reimburses the employer.
  • Self-funded plans with unusual payment routing set up by the plan sponsor.
  • Missing assignment of benefits, so the payer sends payment somewhere other than the provider.
  • Work-related claims handled through an employer rather than a workers’ comp carrier.

How to handle it

  1. Confirm whether the employer already paid you for the service. If so, reconcile the account rather than chasing the plan payment.
  2. If the employer hasn’t paid, contact it with the remittance and request payment.
  3. Check assignment of benefits in your records. If the patient assigned benefits to your practice, ask the payer to reissue payment to you.
  4. Ask the payer to explain the payment direction if you have no employer relationship.
  5. Avoid billing the patient for the paid amount.

How to prevent it

  • Separate employer-paid services from insurance-billed services in your scheduling and billing workflow.
  • Collect signed assignment of benefits at registration.
  • Document employer agreements so staff know which services are billed to the employer directly.
  • Watch for redirected payments. An ERA Analyzer can surface CO-293 lines so they’re followed up quickly.

Specialty notes

Occupational medicine clinics and practices offering employer health services encounter CO-293 most often. Keep employer billing and health-plan billing on separate accounts to avoid double collection.

Remark codes that may appear with CO-293

  • M40 (Claim must be assigned and must be filed by the practitioner's employer.): The claim must be assigned and filed by the practitioner's employer, a related Medicare rule for employed practitioners.
  • CO-294 (Payment made to attorney.): Payment made to an attorney instead of the provider.
  • CO-100 (Payment made to patient/insured/responsible party.): Payment made to the patient, insured, or responsible party.
  • OA-19 (This is a work-related injury/illness and thus the liability of the Worker's Compensation Carrier.): Work-related injury; the workers' compensation carrier is responsible.
  • CO-139 (Contracted funding agreement - Subscriber is employed by the provider of services.): Contracted funding agreement where the subscriber is employed by the provider.

CO-293 FAQ

Why would a payer pay an employer instead of the provider?

Common situations include employer-arranged services such as occupational health programs, employer-paid physicals or screenings, some self-funded plan arrangements, or cases where the employer paid the provider up front and is being reimbursed.

How do I collect after CO-293?

Contact the employer with the claim details and the remittance showing payment was sent to them. If you have an agreement with the employer, bill under its terms.

What if the practice never agreed to employer payment?

Ask the payer why payment was redirected and whether an assignment of benefits to your practice was on file. If assignment was valid, request that the payer correct the payment.

Can I bill the patient for a CO-293 amount?

Generally no. The service was paid; the question is who received the money. Pursue the employer or the payer, not the patient.