OA P10 denial code
Claim adjustment reason code P10. Often reported as OA P10 or CO P10.
Payment held at zero during a lawsuit
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 .
What P10 means
The property and casualty payer reduced payment to zero because the claim is in litigation, with more to follow later.
It belongs to property and casualty billing, such as workers' compensation or auto medical claims. The claim is tied up in a lawsuit, so the payer is paying nothing for now. It signals that more information will come once the litigation finishes.
This is a holding position rather than a final decision. Keep the account open and track the case.
Group codes seen with P10
On a remittance, P10 comes after a group code. These are the ones it is most often reported with:
- OA P10 (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.
- CO P10 (Contractual Obligation): The provider's side of the ledger. The reduction comes from the payer contract or a rule the provider has to follow, and the patient normally cannot be billed for it.
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
- The patient's claim or the carrier's liability is being litigated.
- The carrier is disputing coverage in court.
- A third party lawsuit affects who will pay.
What to do next
- Ask the adjuster or the patient's attorney for the case status and contact details.
- Consider whether a lien or letter of protection applies under your policy and the state's rules.
- Hold the balance and follow up when the litigation ends.
Related codes
Source
Official wording: X12 Claim Adjustment Reason Codes list. The explanation on this page is our own plain-English wording, not the X12 text.
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