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OA-255 Denial Code (Deactivated): P&C Claim in Litigation

OA-255 meant the related property and casualty claim for the injury or illness was pending because of litigation, so the medical claim could not be decided yet. X12 deactivated it and its notes direct payers to code P11.

X12 deactivated CARC255 on July 1, 2014. Payers should no longer use it on new remittances, but it can still appear on older ERAs, corrected claims, and appeals.

Code: OA-255 (CARC 255)
Status: Deactivated StoppedJuly 1, 2014 (in use since June 2, 2013).
Code set: Claim Adjustment Reason Codes (CARC)
Group codes: OA (Other Adjustment): The only group allowed for this code: neither the provider nor the patient was assigned responsibility while the case was pending.
Official description: The disposition of the related Property & Casualty claim (injury or illness) is pending due to litigation. (Use only with Group Code OA)
X12 Claim Adjustment Reason Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What OA-255 meant

CARC 255 applied when a medical bill depended on a property and casualty claim, such as an auto or liability claim for the injury, and that claim was tied up in a lawsuit. Until the litigation was resolved, the payer would not decide whether the medical services were payable. The code could only be used with group OA.

What replaced it

X12’s note says to use code P11. OA-P11 carries the same meaning and the same OA-only restriction. When the payer reports a zero payment because of the lawsuit, it uses CO-P10. For other pending reviews outside property and casualty, OA-133 is available.

If you still see OA-255

Older property and casualty files may carry it. Keep the claim open and document the case number and attorneys involved. Check back with the adjuster periodically and after any settlement or judgment, then ask the payer to reprocess. Whether and when you can bill other coverage or the patient depends on the jurisdiction and any lien arrangements.

OA-P11 (The disposition of the related Property & Casualty claim (injury or illness) is pending due to litigation.): Named replacement: related property and casualty claim pending due to litigation.
CO-P10 (Payment reduced to zero due to litigation.): Payment reduced to zero due to litigation.
OA-133 (The disposition of this service line is pending further review. (Use only with Group Code OA).): The disposition of the line is pending further review.

OA-255 FAQ

Why was OA-255 limited to the OA group?

Because a pending decision is not a contractual reduction or a patient liability. The OA group signals that the amount is not yet assigned to anyone.

How is OA-255 different from CO-244?

CO-244 reduced payment to zero because of litigation. OA-255 said the related injury claim itself was pending in litigation, without assigning the amount to the provider.

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