CARC 152 Active

OA-152: Documentation Does Not Support Length of Service

TL;DR

Service duration adjustment classified as a general adjustment. Verify time documentation and correct or appeal.

Action
Review & Decide
Who Pays
Depends
Appeal
Yes
Patient Impact
Indirect
Disclaimer
This content is for informational purposes only and does not constitute professional billing advice. Always verify information against your payer contracts and current coding guidelines. Consult a certified billing specialist for specific claim issues.

What Does OA-152 Mean?

OA-152 is uncommon and may appear when the length-of-service adjustment is informational. The resolution approach mirrors CO-152 — review time documentation and either appeal or correct.

CARC 152 appears on your remittance when the payer has reviewed your claim and concluded that the clinical documentation does not justify the length or duration of the service that was billed. This is distinct from CARC 150 (level of service) and CARC 151 (frequency of service) — CARC 152 specifically targets how long the individual service lasted.

The most common scenario involves time-based billing codes. If you billed four units of a timed service (indicating 45-60 minutes), but your clinical notes only document 30 minutes of treatment, the payer will deny the excess units with CARC 152. This denial is particularly prevalent in therapy services (physical therapy, occupational therapy, speech therapy), prolonged services, observation care, and anesthesia where time documentation directly drives billing. Missing start and stop times in the clinical record is one of the most frequent triggers.

The denial almost always appears under the CO group code, making the provider responsible for the adjustment. You cannot bill the patient for the time difference. If your clinical records actually do support the billed duration — for example, the clinician documented the treatment time in the narrative but forgot to record start/stop times — an appeal with the full clinical record may succeed. If the documentation genuinely does not support the billed length, correct the claim to reflect the documented duration. Recurring CARC 152 denials are a strong signal that your clinical staff needs training on time documentation requirements for time-based services.

How to Resolve

Verify that your time documentation supports the billed service duration, then either appeal with detailed records or correct the claim to the documented length.

  1. Review the ERA for specifics Check the RARC codes and any payer policy references for details about the duration dispute.
  2. Follow the CO-152 resolution process Verify time documentation, compare against payer rules, and either appeal or correct the claim.

How to Prevent OA-152

Also Filed As

The same CARC 152 may appear with different Group Codes:

Related Denial Codes

Sources

  1. https://www.mdclarity.com/denial-code/152
  2. https://docs.claim.md/docs/claim-adjustment-reason-codes
  3. Codes maintained by X12. Visit x12.org for official definitions.