OA-262: Pharmaceutical Delivery Cost Adjustment

What Does OA-262 Mean?

OA-262 indicates the delivery cost adjustment does not fall into standard contractual or patient responsibility categories, typically appearing in coordination of benefits situations. The primary payer may be signaling that the delivery cost should be evaluated by a secondary payer.

When CARC 262 appears on a remittance, the payer has specifically adjusted the delivery cost component of a pharmaceutical claim. This code exists exclusively for pharmaceutical billing and signals that the charges associated with physically delivering medication to the patient — courier fees, transportation costs, or specialized handling charges — were not reimbursed at the billed amount. The payer may have reduced the delivery charge to a lower allowed amount or denied it entirely.

This adjustment is distinct from CARC 263 (shipping), 264 (postage), and 265 (administrative) — all of which also apply only to pharmaceuticals. CARC 262 targets the actual delivery logistics cost. Specialty pharmacies, home infusion providers, and mail-order pharmacies encounter this code most frequently because delivery is a core part of their service model. For traditional retail pharmacies, this code is less common since patients typically pick up medications in person.

Under Group Code CO, the delivery cost adjustment is a contractual write-off that cannot be passed to the patient. This is the most common scenario — the payer's contract either excludes delivery charges or caps them at a specific rate. Before writing off the amount, verify that the correct delivery charge codes were used and that the payer applied the right fee schedule. If your contract explicitly covers delivery costs and the payer adjusted them in error, you have grounds for appeal or reprocessing.

Common Causes

How to Resolve

Verify whether delivery costs are covered under your payer contract, correct any coding errors, and resubmit or write off the adjustment.

1. Identify secondary payer coverage Check the patient's records for secondary insurance that may cover pharmaceutical delivery costs.
2. Forward the claim to the next payer Submit the delivery charge to the secondary payer with the primary remittance attached showing the OA-262 adjustment.
3. Post the final balance appropriately After all payers have adjudicated, post any remaining balance per your contract terms.

How to Prevent OA-262

• Collect complete insurance information during patient intake to ensure proper payer sequencing for pharmaceutical claims
• Set up automated workflows to identify OA adjustments that need secondary payer submission

General Prevention

• Maintain accurate documentation of all pharmaceutical delivery costs including invoices, receipts, and delivery confirmations
• Verify that the patient's plan covers pharmaceutical delivery charges before billing
• Ensure delivery costs are properly separated from drug costs on the claim and use correct billing codes
• Conduct regular audits of pharmaceutical delivery billing to catch calculation and coding errors
• Stay current with payer-specific guidelines on allowable delivery charges and billing requirements

Also Filed As

The same CARC 262 may appear with different Group Codes:

Related Denial Codes