OA-22 — May be covered by another payer (COB)
Also seen as: OA-22, PR-22
What it means
The payer thinks someone else is primary — another plan, a spouse's plan, Medicare — and wants that billed first. Common when a patient has two coverages.
Standard definition (paraphrased): Under coordination-of-benefits rules, a different plan may need to pay this first.
Why it happens
- • The patient has more than one insurance and COB order isn't on file
- • The payer's records show another plan as primary
- • COB information at the plan is outdated
Common next steps therapists take
- • Confirm which plan is primary with the patient
- • Have the patient update COB with the payer, then rebill in the correct order
Educational information only
This page is general educational information, not legal, billing, or medical advice, and not a determination about any specific claim. Denial codes are maintained by the X12 committee and updated periodically. Always verify code meanings, benefits, and requirements directly with the payer and against your own records.
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Superbilled generates insurance-ready superbills with the correct codes and modifiers, so fewer claims come back with a code like OA-22 to decode.
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