Instantly find explanations, causes, and resolution steps for every Claim Adjustment Reason Code (CARC) and Remark Code.
Claim Adjustment Reason Codes (CARC) explain why a payment differs from what was billed. Every 835 ERA and EOB uses these standardized codes.
Search any code or keyword above. Each page includes the full description, common causes, resolution steps, and appeal guidance.
Each denial code page also links to a dedicated Remark Code page — optimized for providers searching for ERA remark code context.
Most denials are reversible. Our guides walk you through the correct steps to correct, resubmit, or formally appeal each denial type.
| Code | Description | View |
|---|---|---|
| N583 | Patient was not an occupant of our insured vehicle and therefore, is not an eligible … | Details → |
| N583 | Patient was not an occupant of our insured vehicle and therefore, is not an eligible … | Details → |
| N584 | Not covered based on the insured's noncompliance with policy or statutory conditions. | Details → |
| N584 | Not covered based on the insured's noncompliance with policy or statutory conditions. | Details → |
| N585 | Benefits are no longer available based on a final injury settlement. | Details → |
| N585 | Benefits are no longer available based on a final injury settlement. | Details → |
| N586 | The injured party does not qualify for benefits. | Details → |
| N586 | The injured party does not qualify for benefits. | Details → |
| N587 | Policy benefits have been exhausted. | Details → |
| N587 | Policy benefits have been exhausted. | Details → |
| N588 | The patient has instructed that medical claims/bills are not to be paid. | Details → |
| N588 | The patient has instructed that medical claims/bills are not to be paid. | Details → |
| N589 | Coverage is excluded to any person injured as a result of operating a motor vehicle w… | Details → |
| N589 | Coverage is excluded to any person injured as a result of operating a motor vehicle w… | Details → |
| N59 | Alert: Please refer to your provider manual for additional program and provider infor… | Details → |
| N59 | Alert: Please refer to your provider manual for additional program and provider infor… | Details → |
| N590 | Missing independent medical exam detailing the cause of injuries sustained and medica… | Details → |
| N590 | Missing independent medical exam detailing the cause of injuries sustained and medica… | Details → |
| N591 | Payment based on an Independent Medical Examination (IME) or Utilization Review (UR). | Details → |
| N591 | Payment based on an Independent Medical Examination (IME) or Utilization Review (UR). | Details → |
| N592 | Adjusted because this is not the initial prescription or exceeds the amount allowed f… | Details → |
| N592 | Recertified or revised Certificate of Medical Necessity (CMN) or DME Information Form… | Details → |
| N592 | Adjusted because this is not the initial prescription or exceeds the amount allowed f… | Details → |
| N593 | Not covered based on failure to attend a scheduled Independent Medical Exam (IME). | Details → |
| N593 | Not covered based on failure to attend a scheduled Independent Medical Exam (IME). | Details → |
| N594 | Records reflect the injured party did not complete an Application for Benefits for th… | Details → |
| N594 | Records reflect the injured party did not complete an Application for Benefits for th… | Details → |
| N595 | Records reflect the injured party did not complete an Assignment of Benefits for this… | Details → |
| N595 | Records reflect the injured party did not complete an Assignment of Benefits for this… | Details → |
| N596 | Records reflect the injured party did not complete a Medical Authorization for this l… | Details → |
| N596 | Records reflect the injured party did not complete a Medical Authorization for this l… | Details → |
| N597 | Adjusted based on a medical/dental provider's apportionment of care between related i… | Details → |
| N597 | Adjusted based on a medical/dental provider's apportionment of care between related i… | Details → |
| N598 | Health care policy coverage is primary. | Details → |
| N598 | Health care policy coverage is primary. | Details → |
| N599 | Our payment for this service is based upon a reasonable amount pursuant to both the t… | Details → |
| N599 | Our payment for this service is based upon a reasonable amount pursuant to both the t… | Details → |
| N6 | Under FEHB law (U.S.C. 8904(b)), we cannot pay more for covered care than the amount … | Details → |
| N6 | Under FEHB law (U.S.C. 8904(b)), we cannot pay more for covered care than the amount … | Details → |
| N60 | A valid NDC is required for payment of drug claims effective October 02. | Details → |
| N60 | A valid NDC is required for payment of drug claims effective October 02. | Details → |
| N600 | Adjusted based on the applicable fee schedule for the region in which the service was… | Details → |
| N600 | Adjusted based on the applicable fee schedule for the region in which the service was… | Details → |
| N601 | In accordance with Hawaii Administrative Rules, Title 16, Chapter 23 Motor Vehicle In… | Details → |
| N601 | In accordance with Hawaii Administrative Rules, Title 16, Chapter 23 Motor Vehicle In… | Details → |
| N602 | Adjusted based on the Redbook maximum allowance. | Details → |
| N602 | Adjusted based on the Redbook maximum allowance. | Details → |
| N603 | This fee is calculated according to the New Jersey medical fee schedules for Automobi… | Details → |
| N603 | This fee is calculated according to the New Jersey medical fee schedules for Automobi… | Details → |
| N604 | In accordance with New York No-Fault Law, Regulation 68, this base fee was calculated… | Details → |
| N604 | In accordance with New York No-Fault Law, Regulation 68, this base fee was calculated… | Details → |
| N605 | This fee was calculated based upon New York All Patients Refined Diagnosis Related Gr… | Details → |
| N605 | This fee was calculated based upon New York All Patients Refined Diagnosis Related Gr… | Details → |
| N606 | The Oregon allowed amount for this procedure is based upon the Workers Compensation F… | Details → |
| N606 | The Oregon allowed amount for this procedure is based upon the Workers Compensation F… | Details → |
| N607 | Service provided for non-compensable condition(s). | Details → |
| N607 | Service provided for non-compensable condition(s). | Details → |
| N608 | The fee schedule amount allowed is calculated at 110% of the Medicare Fee Schedule fo… | Details → |
| N608 | The fee schedule amount allowed is calculated at 110% of the Medicare Fee Schedule fo… | Details → |
| N609 | 80% of the provider's billed amount is being recommended for payment according to Act… | Details → |
Medical claim denial codes — formally known as Claim Adjustment Reason Codes (CARC) — are standardized identifiers maintained by the X12 standards body and used across all Medicare, Medicaid, and commercial payer 835 electronic remittance transactions. When a claim is paid at a different amount than billed, at least one CARC code must accompany the remittance advice to indicate the specific reason for the adjustment.
The most frequently encountered codes include CO-16 (missing or invalid claim information), CO-45 (charges exceeding fee schedule), PR-1 (patient deductible), CO-29 (timely filing deadline exceeded), and CO-4 (procedure code inconsistent with modifier). Each represents a distinct, actionable reason that has a defined resolution pathway.