DenialCode.com
Free Healthcare Billing Reference

Medical Denial Code
Lookup Tool

Instantly find explanations, causes, and resolution steps for every Claim Adjustment Reason Code (CARC) and Remark Code.

Popular: CO-16 CO-45 PR-1 CO-29 CO-4 CO-45 Remark Code
4,524+
Denial Codes
5
Group Code Types
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Always Free
2024
Updated CARC List
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What Are Denial Codes?

Claim Adjustment Reason Codes (CARC) explain why a payment differs from what was billed. Every 835 ERA and EOB uses these standardized codes.

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How to Use This Tool

Search any code or keyword above. Each page includes the full description, common causes, resolution steps, and appeal guidance.

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Remark Codes Too

Each denial code page also links to a dedicated Remark Code page — optimized for providers searching for ERA remark code context.

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Appeal Your Denial

Most denials are reversible. Our guides walk you through the correct steps to correct, resubmit, or formally appeal each denial type.

Claim Adjustment Reason Codes
Showing 4,524 codes — click any code for full explanation and resolution steps
Code Description View
N716Missing chart.Details →
N717Incomplete/Invalid documentation of face-to-face examination.Details →
N717Incomplete/Invalid documentation of face-to-face examination.Details →
N718Missing documentation of face-to-face examination.Details →
N718Missing documentation of face-to-face examination.Details →
N719Penalty applied based on plan requirements not being met.Details →
N719Penalty applied based on plan requirements not being met.Details →
N72PPS (Prospective Payment System) code changed by medical reviewers. Not supported by …Details →
N72PPS (Prospective Payment System) code changed by medical reviewers. Not supported by …Details →
N720Alert: The patient overpaid you. You may need to issue the patient a refund for the d…Details →
N720Alert: The patient overpaid you. You may need to issue the patient a refund for the d…Details →
N721This service is only covered when performed as part of a clinical trial.Details →
N721This service is only covered when performed as part of a clinical trial.Details →
N722Patient must use Workers' Compensation Set-Aside (WCSA) funds to pay for the medical …Details →
N722Patient must use Workers' Compensation Set-Aside (WCSA) funds to pay for the medical …Details →
N723Patient must use Liability set-aside (LSA) funds to pay for the medical service or it…Details →
N723Patient must use Liability set-aside (LSA) funds to pay for the medical service or it…Details →
N724Patient must use No-Fault set-aside (NFSA) funds to pay for the medical service or it…Details →
N724Patient must use No-Fault set-aside (NFSA) funds to pay for the medical service or it…Details →
N725A liability insurer has reported having ongoing responsibility for medical services (…Details →
N725A liability insurer has reported having ongoing responsibility for medical services (…Details →
N726A conditional payment is not allowed.Details →
N726A conditional payment is not allowed.Details →
N727A no-fault insurer has reported having ongoing responsibility for medical services (O…Details →
N727A no-fault insurer has reported having ongoing responsibility for medical services (O…Details →
N728A workers' compensation insurer has reported having ongoing responsibility for medica…Details →
N728A workers' compensation insurer has reported having ongoing responsibility for medica…Details →
N729Missing patient medical/dental record for this service.Details →
N729Missing patient medical/dental record for this service.Details →
N73A Skilled Nursing Facility is responsible for payment of outside providers who furnis…Details →
N73A Skilled Nursing Facility is responsible for payment of outside providers who furnis…Details →
N730Incomplete/invalid patient medical/dental record for this service.Details →
N730Incomplete/invalid patient medical/dental record for this service.Details →
N731Incomplete/Invalid mental health assessment.Details →
N731Incomplete/Invalid mental health assessment.Details →
N732Services performed at an unlicensed facility are not reimbursable.Details →
N732Services performed at an unlicensed facility are not reimbursable.Details →
N733Regulatory surcharges are paid directly to the state.Details →
N733Regulatory surcharges are paid directly to the state.Details →
N734The patient is eligible for these medical services only when unable to work or perfor…Details →
N734The patient is eligible for these medical services only when unable to work or perfor…Details →
N735Adjustment without review of medical/dental record because the requested records were…Details →
N735Adjustment without review of medical/dental record because the requested records were…Details →
N736Incomplete/invalid Sleep Study Report.Details →
N736Incomplete/invalid Sleep Study Report.Details →
N737Missing Sleep Study Report.Details →
N737Missing Sleep Study Report.Details →
N738Incomplete/invalid Vein Study Report.Details →
N738Incomplete/invalid Vein Study Report.Details →
N739Missing Vein Study Report.Details →
N739Missing Vein Study Report.Details →
N74Resubmit with multiple claims, each claim covering services provided in only one cale…Details →
N74Resubmit with multiple claims, each claim covering services provided in only one cale…Details →
N740The member's Consumer Spending Account does not contain sufficient funds to cover the…Details →
N740The member's Consumer Spending Account does not contain sufficient funds to cover the…Details →
N741This is a site neutral payment.Details →
N741This is a site neutral payment.Details →
N742Alert: This claim was processed based on one or more ICD-9 codes. The transition to I…Details →
N742Alert: This claim was processed based on one or more ICD-9 codes. The transition to I…Details →
N743Adjusted because the services may be related to an employment accident.Details →

Understanding Medical Claim Denial Codes

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.