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 |
|---|---|---|
| N880 | Original claim closed due to changes in submitted data. Adjustment claim will be proc… | Details → |
| N880 | Original claim closed due to changes in submitted data. Adjustment claim will be proc… | Details → |
| N881 | Client Obligation, patient responsibility for Home & Community Based Services (HCBS) | Details → |
| N881 | Client Obligation, patient responsibility for Home & Community Based Services (HCBS) | Details → |
| N882 | Alert: The out-of-network payment and cost sharing amounts were based on the plan's a… | Details → |
| N882 | Alert: The out-of-network payment and cost sharing amounts were based on the plan's a… | Details → |
| N883 | Alert: Processed according to state law | Details → |
| N883 | Alert: Processed according to state law | Details → |
| N884 | Alert: The No Surprises Act may apply to this claim. Please contact payer for instruc… | Details → |
| N884 | Alert: The No Surprises Act may apply to this claim. Please contact payer for instruc… | Details → |
| N885 | Alert: This claim was not processed in accordance with the No Surprises Act cost-shar… | Details → |
| N885 | Alert: This claim was not processed in accordance with the No Surprises Act cost-shar… | Details → |
| N89 | Alert: Payment information for this claim has been forwarded to more than one other p… | Details → |
| N89 | Alert: Payment information for this claim has been forwarded to more than one other p… | Details → |
| N9 | Adjustment represents the estimated amount a previous payer may pay. | Details → |
| N9 | Adjustment represents the estimated amount a previous payer may pay. | Details → |
| N90 | Covered only when performed by the attending physician. | Details → |
| N90 | Covered only when performed by the attending physician. | Details → |
| N91 | Services not included in the appeal review. | Details → |
| N91 | Services not included in the appeal review. | Details → |
| N92 | This facility is not certified for digital mammography. | Details → |
| N92 | This facility is not certified for digital mammography. | Details → |
| N93 | A separate claim must be submitted for each place of service. Services furnished at m… | Details → |
| N93 | A separate claim must be submitted for each place of service. Services furnished at m… | Details → |
| N94 | Claim/Service denied because a more specific taxonomy code is required for adjudicati… | Details → |
| N94 | Claim/Service denied because a more specific taxonomy code is required for adjudicati… | Details → |
| N95 | This provider type/provider specialty may not bill this service. | Details → |
| N95 | This provider type/provider specialty may not bill this service. | Details → |
| N96 | Patient must be refractory to conventional therapy (documented behavioral, pharmacolo… | Details → |
| N96 | Patient must be refractory to conventional therapy (documented behavioral, pharmacolo… | Details → |
| N97 | Patients with stress incontinence, urinary obstruction, and specific neurologic disea… | Details → |
| N97 | Patients with stress incontinence, urinary obstruction, and specific neurologic disea… | Details → |
| N98 | Patient must have had a successful test stimulation in order to support subsequent im… | Details → |
| N98 | Patient must have had a successful test stimulation in order to support subsequent im… | Details → |
| N99 | Patient must be able to demonstrate adequate ability to record voiding diary data suc… | Details → |
| N99 | Patient must be able to demonstrate adequate ability to record voiding diary data suc… | Details → |
| P01 | Go to lni wa gov website to print & complete a provider application. | Details → |
| P02 | Paid. One-time only provider number authorized. | Details → |
| P03 | Provider name corrected to match number. Bill with correct name for provider number/N… | Details → |
| P04 | Payee number is missing. For information contact Electronic Billing Unit at 360-902-6… | Details → |
| P05 | Payee name/number missing or invalid. For more information contact the Electronic Bil… | Details → |
| P06 | Denied. Records do not show the provider/group account numbers as related. Call 1-800… | Details → |
| P07 | Payment made as result of provider audit. | Details → |
| P08 | Adjustment done to correct invalid provider/payee connection. | Details → |
| P09 | Line adjusted due to refund. Other lines may adjust due to payment policies. | Details → |
| P1 | State-mandated Requirement for Property and Casualty, see Claim Payment Remarks Code … | Details → |
| P10 | Payment reduced to zero due to litigation. Additional information will be sent follow… | Details → |
| P10 | Refund applies to related bill adjustment(s) which may affect multiple claim numbers. | Details → |
| P11 | The disposition of the related Property & Casualty claim (injury or illness) is pendi… | Details → |
| P11 | This transaction reflects a refund that clears a credit balance and corrects year to … | Details → |
| P12 | Workers' compensation jurisdictional fee schedule adjustment. Usage: If adjustment is… | Details → |
| P12 | Processed per direction of the Provider Review and Education Section. | Details → |
| P13 | Payment reduced or denied based on workers' compensation jurisdictional regulations o… | Details → |
| P13 | The performing and/or payee provider account number was terminated at your request. F… | Details → |
| P14 | The Benefit for this Service is included in the payment/allowance for another service… | Details → |
| P14 | Denied. Use of this procedure code is invalid for this provider type on this date of … | Details → |
| P15 | Workers' Compensation Medical Treatment Guideline Adjustment. To be used for Workers'… | Details → |
| P15 | Denied. 1101M cannot be billed without 1100M. Please correct and rebill using appropr… | Details → |
| P16 | Medical provider not authorized/certified to provide treatment to injured workers in … | Details → |
| P16 | Denied. Our records indicate the injured worker did not take the flight. | 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.