CARC 23: The impact of prior payer(s) adjudication including payments and/or adjustments.
Secondary carrier is adjusting based on what the primary paid. Informational — confirms COB processing.
CARC 23 appears on the 835 ERA (Electronic Remittance Advice) that the payer returns after claim adjudication. It explains a reduction, denial, or payment adjustment to your billing team. For your practice, the question is workflow: identify the pattern, route the denial to the right resolution path (rebill, appeal, write-off), and recover what's recoverable without burning RVU time on dead-end fights.
What CARC 23 means
The official X12 description is: “The impact of prior payer(s) adjudication including payments and/or adjustments.”
In plain language: Secondary carrier is adjusting based on what the primary paid. Informational — confirms COB processing.
Common scenarios
- Medicare + Medigap
- Commercial + spouse's commercial
- Auto + health
Practice workflow for CARC X 23
Verify the math against the primary's EOB. If incorrect, dispute with the secondary carrier.
CARC 23 group codes explained
On the 835 ERA, CARC 23 appears alongside a group code that signals who is financially responsible for the adjustment. OA (Other Adjustment) — Informational or coordination-related adjustment. Usually means another payer is involved or there's a non-claim-related accounting entry.
Frequently asked questions
What does CARC 23 mean?
The impact of prior payer(s) adjudication including payments and/or adjustments. In plain language: Secondary carrier is adjusting based on what the primary paid. Informational — confirms COB processing.
Is CARC 23 appealable?
CARC 23 is usually not appealable on its own — it's typically a contractual, informational, or routine adjustment. Verify the math against the primary's EOB. If incorrect, dispute with the secondary carrier.
Which group code does CARC 23 appear under?
CARC 23 most often appears under: OA (Other Adjustment) — Informational or coordination-related adjustment. Usually means another payer is involved or there's a non-claim-related accounting entry.
When does CARC 23 typically appear on a denial?
Common scenarios: Medicare + Medigap; Commercial + spouse's commercial; Auto + health.
What should I do if I see CARC 23 on the 835?
Verify the math against the primary's EOB. If incorrect, dispute with the secondary carrier.
Related resources
Sources
Contact: hello@approvalhelp.com