OA-107: Related or Qualifying Service Not Identified

What Does OA-107 Mean?

OA-107 is an other adjustment used when the missing linking information is an administrative issue that does not fall neatly into contractual obligation or patient responsibility. This may occur when the payer system cannot process the claim due to a systemic linking error or when the qualifying service was processed by a different entity.

CARC 107 fires when a payer's system cannot locate the connection between the submitted claim and a related or qualifying service it depends on. Every dependent service — follow-up visits, post-operative care, secondary procedures tied to an initial qualifying claim — requires a reference linking it back to the original. When that reference is missing or incorrect, the payer cannot validate the relationship and denies the claim.

This is fundamentally a data completeness issue, not a coverage dispute. The service itself may be perfectly valid, but the claim lacks the linking information the payer needs to process it. The 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF) often contains specific guidance about what reference is required. Common missing elements include original claim ICN numbers, prior authorization references, or qualifying procedure identifiers.

CO is the dominant group code for CARC 107 because the missing linking data is the provider's responsibility to include. The resolution is straightforward: identify the correct reference, add it to the claim, and resubmit. This is not a denial that requires an appeal — it requires a data correction.

How to Resolve

Locate the missing related claim or service reference, add it to the claim, and resubmit with complete linking information.

1. Review the adjustment details Check the remittance for guidance on what linking information is needed and whether the qualifying service was processed by this payer or a different entity.
2. Coordinate across payers if needed If the qualifying service was processed by a different payer (e.g., primary vs. secondary), obtain the claim reference from the other payer and include it in the resubmission.
3. Add the reference and resubmit Update the claim with the correct linking information and resubmit to the appropriate payer.

How to Prevent OA-107

• Track qualifying claims across multiple payers for patients with coordination of benefits to ensure linking references are available for dependent services
• Maintain a log of original claim references for complex cases involving multiple payers

Also Filed As

The same CARC 107 may appear with different Group Codes:

Related Denial Codes