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 is the code your insurance company used to explain why your claim was reduced, denied, or paid less than expected. It appears on your Explanation of Benefits (EOB) — the statement your plan sends after a claim is processed. Here's what it means for you and what you can do about it.
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
What to do next 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@denialhelp.com