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CARC 22Other payer may be primaryCOB information needed

CARC 22: Coordination of Benefits and Payer Order

This denial family commonly indicates that another payer may have primary responsibility or that primary-payer adjudication data is missing or inconsistent.

First checks

  1. 1Verify all active coverage for the service date.
  2. 2Determine primary responsibility under the applicable COB or MSP rule.
  3. 3Check whether the primary EOB or 835 data reached the secondary payer.

Resolution path

  1. 01Correct payer-order records when inaccurate.
  2. 02Bill the correct primary payer.
  3. 03After primary adjudication, submit a compliant secondary claim with COB data.
  4. 04Use the appropriate Medicare coverage-development channel when CMS records are wrong.

Evidence packet

  • Eligibility and coverage response
  • Primary payer EOB or ERA
  • Employment, accident, ESRD, or other payer-order facts

Prevent the next denial

Ask current coverage and employment questions, verify payer order for the date of service, and transmit complete primary adjudication data on secondary claims.

Official sources

CMS Health Care Payment and Remittance AdviceReviewed 2026-07-10Medicare Secondary PayerReviewed 2026-07-10

Use the current payer notice, contract, code set, policy, and filing instructions. This guide is educational and does not determine patient liability or appeal rights for an individual claim.