CO P32 denial code
Claim adjustment reason code P32. Often reported as CO P32 or OA P32.
Liability split, partial payment
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 P32 means
The payment was reduced because liability for the condition was apportioned, with only part of it assigned to this payer.
Apportionment splits responsibility for a condition between causes, for example between a work injury and a pre-existing condition or an earlier injury. P32 means the payer paid only its share after that split.
It is seen mostly on workers' compensation and other property and casualty claims. The rest of the balance may belong to another payer, depending on the apportionment decision.
Group codes seen with P32
On a remittance, P32 comes after a group code. These are the ones it is most often reported with:
- CO P32 (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.
- OA P32 (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 decision assigned only part of the disability or treatment to the injury.
- Another injury or a pre-existing condition was found responsible for part of the care.
- Two carriers share liability for the claim.
What to do next
- Ask the adjuster for the apportionment decision and the percentage applied.
- Identify any other payer responsible for the rest and bill them.
- Dispute the apportionment through the applicable process if it seems wrong.
Related codes
- P12 (reason code) Workers' comp fee schedule adjustment
- P13 (reason code) Reduced under workers' comp rules
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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