OA-23
Impact of prior payer(s) adjudication including payments and/or adjustments
What This Code Means
This adjustment reflects amounts already paid or adjusted by a prior payer in a coordination-of-benefits scenario; it is informational rather than a new denial.
Common Causes
- Secondary payer processing after primary payer already paid
- Claim correctly following COB sequencing
How to Resolve or Appeal
- Confirm the primary payer's EOB/835 matches what's reflected here
- No action typically needed if COB sequencing is correct
- Investigate only if the secondary payment doesn't reconcile with expectations
Educational reference only — not medical or legal advice. Always confirm code usage and appeal rights with the specific payer.