CO-143: Portion of Payment Deferred

What Does CO-143 Mean?

CO-143 appears when the deferred amount falls under a contractual arrangement — most commonly a managed care withhold provision where a percentage of payment is held back and distributed later based on quality or utilization metrics. Under CO, the deferred amount is part of the contractual payment structure. The provider should track these withholds and follow up at the contractually specified distribution period (quarterly, semi-annually, or annually).

CARC 143 is not a denial in the traditional sense. When a payer issues CARC 143, they are telling you that they have processed the claim but are withholding a portion of the payment. The claim is not rejected — part of it may already be paid — but the remaining amount is on hold until certain conditions are met. The specific reason for the deferral varies and is communicated through the accompanying RARC code.

The most common reasons for payment deferral include pending documentation requests (the payer needs medical records or operative notes before releasing the full payment), unresolved coordination of benefits (the primary payer has not yet adjudicated the claim), and managed care withhold arrangements (the contract specifies that a percentage of payment is held back and distributed later based on performance metrics). Medical review or audit is another common trigger — the payer is reviewing a portion of the claim for medical necessity or utilization and deferring payment on that portion while paying the rest.

The key distinction with CARC 143 is that the deferred amount has not been denied. The payer intends to pay it once the conditions are met. This makes tracking and follow-up critical — deferred amounts can fall through the cracks if they are not monitored. Set a follow-up date based on the payer's typical processing timeline, and if the deferred amount is not released within that window, contact the payer proactively.

How to Resolve

Identify why the payment was deferred, provide any requested documentation or information, and track the deferred amount until it is released.

1. Review the contract Check the managed care contract for withhold provisions, including the withhold percentage, distribution schedule, and performance criteria.
2. Track withheld amounts Log all CO-143 adjustments as contractual withholds in your A/R system, separate from standard denials.
3. Follow up at distribution time At the contractually specified distribution period, verify that the withheld amounts are returned per the agreed-upon terms.

How to Prevent CO-143

• Understand the managed care contract's withhold provisions and plan for the deferred revenue in your financial projections
• Track contractual withholds separately from denials to maintain accurate A/R reporting
• Meet quality and utilization targets to maximize withhold distribution

Also Filed As

The same CARC 143 may appear with different Group Codes:

Related Denial Codes