CO-192 denial code
Non standard adjustment code from paper remittance
How to fix it
Contact the payer for the specific reason. The code itself carries no actionable detail.
How to prevent it
Move to electronic remittance advice where possible; paper remittances lose adjudication detail.
In practice
A paper remittance arrives carrying an adjustment identified by a code that does not appear in the standard code set. Nobody can determine what it means from the document.
Paper remittances predate the standard code sets and some payers still use internal codes on them. The code carries meaning inside the payer's system and none outside it.
There is no way to resolve this from the remittance, so the call to the payer is unavoidable. The more durable answer is moving to electronic remittance, where standard codes are mandatory.
What sits behind it
Electronic remittance advice carries adjudication detail that paper systematically loses — line-level adjustments, standardised reason and remark codes, group codes classifying each adjustment. A practice on paper is working with less information on every claim, not just this one.
The transition is usually available and rarely difficult. Most payers support electronic remittance through a clearinghouse or portal, and enrolment is an administrative step rather than a technical project.
Beyond the coding question, paper remittance blocks automated posting entirely, which means staff time on every payment rather than on exceptions. The cost of staying on paper compounds well beyond the occasional unreadable adjustment code.
Related codes
Terms used here — ERA · Payment Posting · Clearinghouse
How we handle it — Revenue Cycle Management · Claims Management · Practice Analytics
Primary sources
The rules behind CO-192, at the bodies that publish them.
- Remittance Advice Remark Codes (RARC) (opens in a new tab)
X12 — The remark codes that qualify a CARC on an ERA. Reading the RARC is usually what tells you whether a denial is appealable.
- CMS-1500 claim form standards (opens in a new tab)
National Uniform Claim Committee — Maintainer of the CMS-1500 professional claim form and its data element definitions, plus the provider taxonomy code set.
- NPI Registry (NPPES) (opens in a new tab)
Centers for Medicare & Medicaid Services — Public lookup and management for National Provider Identifiers. A stale NPPES record is a quietly common cause of enrollment and claim rejections.
Looking for a different code? Search all 190 CARC and RARC codes
Questions about CO-192
Not in any public reference, because it belongs to the payer's internal system rather than the standard code sets. Calling the payer is the only route to meaning, which is itself an argument for moving off paper remittance.
Line-level adjustment detail, standardised reason and remark codes, and group codes classifying each adjustment. Paper loses all of it, so a practice on paper is working with less information on every claim rather than only on the unreadable ones.
Usually not. Most payers support it through a clearinghouse or provider portal and enrolment is an administrative step. The larger gain is automated posting, which moves staff time from every payment onto exceptions only.
Find out what your denials are costing you
A free billing audit reviews your denial rate, AR aging and clean claim rate against industry benchmarks. Takes about two minutes to request. No sales pitch.
No setup fees · You pay when we collect · Pricing from 3% of net collections