CARC 192: Non-Standard Adjustment Code From Paper Remittance

What it means

This code is a placeholder used when a paper remittance advice contained an adjustment reason that doesn't map to a standard electronic CARC code. It essentially means the payer's original paper notice used a non-standard or proprietary code, and the system converting it to electronic format couldn't translate it into one of the official CARC codes. It doesn't describe a specific reason for denial or reduction on its own.

Common causes

Payer issued a paper remittance advice (RA) using an internal or legacy code not part of the standard CARC/RARC code set
A clearinghouse or billing system auto-converted a paper EOB into an 835 electronic file and defaulted to code 192 because no direct match existed
Older or smaller payer systems that have not fully adopted standardized code sets
Data entry or scanning errors when transcribing paper remittance details into electronic claim systems

How to fix it

Locate and review the original paper remittance advice (EOB) to see the actual reason or code the payer used
Contact the payer directly to ask what the original adjustment reason was and why it was reported as non-standard
Check with your clearinghouse or billing software vendor to confirm how the paper-to-electronic translation was handled
Once the true reason is identified, take corrective action based on that actual reason (e.g., resubmit, correct claim data, or appeal)
Document the payer's explanation in your records for audit trail purposes

Appeal / resubmit

Since code 192 itself does not explain the denial or adjustment, an appeal should not be based on this code alone. First obtain the specific reason from the payer's original paper EOB or by calling their provider services line, then file any appeal referencing that actual reason and include supporting documentation (medical records, corrected claim, or proof of timely filing, as applicable).

Frequently asked

What does CARC 192 actually tell me about my claim?

Very little on its own—it indicates the payer's paper remittance used a non-standard code that couldn't be translated into a standard electronic CARC. You'll need to contact the payer to find out the real reason.

Should I resubmit the claim right away?

Not yet. First find out the actual adjustment reason from the payer, since resubmitting without understanding the true issue may result in the same outcome or a new denial.

Is this a payer error or a billing system error?

It can be either—sometimes the payer's internal system uses non-standard codes, and sometimes the electronic translation process (via clearinghouse or software) fails to map the code correctly.

More free billing tools: all denial codes · denial lookup · Medicare fee calculator

This content is informational only and not billing or legal advice. Always verify current requirements with the applicable payer or official code source.