AGAR Guide
CARC23ReferenceCurrentVerified Aug 15, 2026

CARC 23

AR Guide Workflow

Coordination of Benefits

Another plan may be primary, the primary's payment was not applied correctly, or the claim belongs with a different payer under COB rules.

Open denial workflow

AR Guide explanation

What it means

The adjustment reflects how a prior payer's payment and adjustments affect this claim. Used with group code OA.

AR Guide knowledge

Common denial category

Coordination of Benefits — Another plan may be primary, the primary's payment was not applied correctly, or the claim belongs with a different payer under COB rules.

AR Guide knowledge

Common causes

  • Secondary claim processed after primary payment
  • Prior payer's payment applied to patient responsibility

AR Guide knowledge

What AR should verify

  1. Compare the primary payer's EOB/ERA with this adjustment
  2. Confirm the amounts reconcile

AR Guide knowledge

Recommended action

  1. Bill the patient only for the remaining patient responsibility per the plan
  2. If the secondary calculation looks wrong, request a recalculation with the primary EOB

About this guidance: Note

AR Guide knowledge is general reference content written by our team — it is not payer-specific policy and never replaces the payer’s documentation or your contract. Always confirm specifics with the payer.