OA 22: Other Payer Primary
Another plan should pay first.
Get the primary EOB and rebill as secondary. Not an appeal.
See a finished review first
- No patient data
- No BAA
- No charge
- No pitch
What OA 22 means
OA: Other adjustment, most often coordination of benefits.
So it belongs to neither side yet. Work the coordination of benefits before you treat any of it as lost money.
The same code, a different prefix. 22 also arrives as CO 22. The reason for the denial is the same. The prefix decides who pays for it, so the next step is not the same. If your remit says CO 22, read that page instead.
Is It Worth Appealing?
Fix and resubmit. This is a correction, not an appeal. Appealing burns the deadline.
Why It Fires
In the order we see it.
Another plan is primary for this patient on this date of service.
How to Fix OA 22, Step by Step
Get the primary EOB and rebill as secondary. Not an appeal.
- 1Step 1: Read the remark code. Find the remark code printed next to OA 22 on the 835 or EOB. It says what the payer wants back. The usual ones are MA04, N522.
- 2Step 2: Find the cause. Match the denial to one of the cause in Why It Fires above, and fix that one.
- 3Step 3: Do this. Get the primary EOB and rebill as secondary. Not an appeal.
- 4Step 4: Attach the documentation. The primary payer's EOB, submitted with the claim as secondary.
The common mistake. Do not appeal this. It is a rebill as secondary, and appealing delays the money.
Free: the Denial Code Appeal Playbook. 53 codes on one sheet: appeal, fix and resubmit, or let it go, and what to attach. Get the playbook
OA 22 description
Another plan should pay first.
Another plan should pay first. So it belongs to neither side yet. Work the coordination of benefits before you treat any of it as lost money.
This is our plain-English wording, not the official X12 text. X12 asserts copyright over the published descriptions, so we write our own and say what it means for the money rather than restating the code.
Where this comes from. This is our own reading of the code, not the payer's and not a copy of the standards text. We classify it from how these denials actually resolve. Where we are unsure, we say so rather than guessing.
The Remark Code Beside It
The adjustment code says the claim was reduced. The remark code printed next to it says why, and it is the one that tells you what to send back.
Related Codes
Your Questions Answered
What does OA 22 mean?
Another plan should pay first. Other adjustment, most often coordination of benefits.
Can you appeal OA 22?
Fix and resubmit. Get the primary EOB and rebill as secondary. Not an appeal.
Why does OA 22 happen?
Another plan is primary for this patient on this date of service.
What documentation wins a OA 22 appeal?
The primary payer's EOB, submitted with the claim as secondary.
How do I fix a OA 22 denial?
Step 1: Read the remark code. Find the remark code printed next to OA 22 on the 835 or EOB. It says what the payer wants back. Step 2: Find the cause. Match the denial to one cause: Another plan is primary for this patient on this date of service. Step 3: Do this. Get the primary EOB and rebill as secondary. Not an appeal. Step 4: Attach the documentation. The primary payer's EOB, submitted with the claim as secondary.
Most searched: CO 97 · CO 96 · OA 23 · PR 204 · CO 109 · CO 197 · CO 45 · CO 50
How Much of This Is Sitting in Your Write-Off Pile?
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Upload your denial summary for the last 90 days. 4 columns: payer, CARC code, count, billed amount. You get back which were winnable and what they were worth.