OA 192 denial code

Claim adjustment reason code 192. Often reported as OA 192.

Nonstandard code from a paper remit

Unofficial reference. This is our own plain-English explanation, not the official code text. Payer rules differ. Verify with the payer and the official X12 code list. AlphaPrefix is not affiliated with X12, CMS or any payer. Data last updated Nov 11, 2026.

What 192 means

A prior payer's paper remittance used an adjustment that has no standard equivalent, so it is passed along under this code.

You will mostly see this when a secondary claim is built from a primary payer's paper explanation of benefits. The primary used its own reason wording, and it does not map cleanly to deductible, coinsurance or copay.

It belongs to coordination of benefits reporting on the outgoing claim, not to a payer's own decision on your claim. If it appears on a remittance from your payer, the claim data likely needs a second look.

Group codes seen with 192

On a remittance, 192 comes after a group code. These are the ones it is most often reported with:

• OA 192 (Other Adjustment): Used for adjustments that are neither the provider's contractual write-off nor the patient's share. It often appears with coordination of benefits, for example when another payer already paid.

The payer chooses the group code for each adjustment, so the same reason code can appear with another group code on your remittance. Read the two together. More about group codes.

Common causes

• A primary payer sent a paper EOB whose adjustment reasons do not match any standard reason code.
• Billing software converted a paper primary EOB into secondary claim data and could not map one line.
• The primary adjustment was not deductible, coinsurance or copay, so no cost sharing code fit.

What to do next

1. Read the primary payer's paper EOB to see what the unmapped adjustment really was.
2. Map the adjustment to a standard reason code if one fits, and keep this code only when none does.
3. Attach or keep the primary EOB on file in case the secondary payer asks to see it.
4. Check with the secondary payer if they reject claims carrying this code.

Related codes

• 23 (reason code) Prior payer payment affected this claim
• 136 (reason code) Prior payer's coverage rules not followed