CARC 23
Adjusted for what a prior payer already did
Not a denial. The secondary payer is accounting for what the primary already paid or adjusted.
Why you actually get this
- Normal coordination of benefits on a secondary claim.
- The primary payer's contractual adjustment is being carried through.
How to check whether it’s correct
- 01Compare the secondary remittance against the primary to confirm the amounts reconcile.
- 02Verify the patient responsibility carried forward matches the primary's determination.
Rarely worth appealing
This is usually correct processing rather than a denial. Work it only where the arithmetic does not reconcile against the primary remittance.
Often arrives with
Seeing a lot of these?
A single denial is a claim to work. A pattern of the same denial is a process to fix, and the two need completely different responses. A free panel reads ninety days of your claims data and shows which codes actually recur for you.
Claim Adjustment Reason Codes are maintained by X12 as External Code List 139. The official description of this code is theirs and is not reproduced here. Check the authoritative list for current wording and status.