Browse all standardized Remark Codes (RARC) used on Medicare, Medicaid, and commercial payer remittance advice (835 ERA / EOB). Each code includes its RA835 mapping, adjustment group, reason code, and a dedicated resolution guide.
Browse Claim Adjustment Reason Codes — the codes that explain why a payment was reduced or denied.
| Remark Code | Description | RA835 Code | Group | Reason Code | |
|---|---|---|---|---|---|
| A38 | HCPCS CODE NOT ELIGIBLE TO BE BILLED WITH REVENUE CODE PER HFS GUIDELINES. |
M20
Missing/incomplete/invalid HCPCS. |
CO | 16 | View → |
| A39 | APL/HCPCS CODE REQUIRED ON CLAIM |
M20
Missing/incomplete/invalid HCPCS. |
CO | 4 | View → |
| A5 | MEDICARE CLAIM PPS CAPITAL COST OUTLIER AMOUNT. | — | CO | A5 | View → |
| A6 | PRIOR HOSPITALIZATION OR 30 DAY TRANSFER REQUIREMENT NOT MET. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | A6 | View → |
| A7 | PRESUMPTIVE PAYMENT ADJUSTMENT |
N432
Alert: Adjustment based on a Recovery Audit. |
CO | 144 | View → |
| A8 | UNGROUPABLE DRG. |
N208
Missing/incomplete/invalid DRG code. |
CO | A8 | View → |
| ABOR | ABORTION CODES ARE NOT REIMBURSABLE THROUGH THE HEALTH PLAN. PLEASE BILL HFS DIRECTLY. |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 204 | View → |
| ABS | THIS SERVICE HAS BEEN SPLIT OUT FROM THIS CLAIM AND IS BEING PROCESSED UNDER A SEPARATE CLAIM NUMBE… |
M86
Service denied because payment already made for same/s… |
CO | 97 | View → |
| AC | APPEAL DENIED. REFER TO PROVIDER ON ATTACHED AUTH IS NOT THE BILLING PROVIDER | — | CO | 193 | View → |
| ACCU | CLAIM HAS BEEN RE-CALCULATED DUE TO CORRECTION OF DEDUCTIBLE/COINSURANCE. PLEASE REIMBURSE MEMBER A… | — | CO | 45 | View → |
| ADJ | ADJUSTED DUE TO RECEIPT OF CORRECT CLAIM. | — | CO | 169 | View → |
| ADM | ADMINISTRATION CODES ARE NOT REIMBURSABLE THROUGH THE HEALTH PLAN. |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 204 | View → |
| ADMX | ACCIDENTAL DENTAL BENEFITS ARE LIMTIED TO $3000.00. |
N587
Policy benefits have been exhausted. |
CO | P6 | View → |
| ADRG | APR-DRG WAS USED TO PRICE CLAIM. |
N381
Alert: Consult our contractual agreement for restricti… |
CO | 144 | View → |
| AIR | ADDITIONAL INFORMATION RECEIVED DOES NOT WARRANT ADDITIONAL BENEFITS. | — | CO | 193 | View → |
| AL | APPEAL DENIED. LETTER SENT UNDER SEPARATE COVER. | — | CO | 193 | View → |
| AMAU | EMERGENCY TRANSFERS MUST BE BILLED WITH APPROPRIATE MODIFIER. NON-EMERGENCY TRANSFERS REQUIRE AUTH… |
N572
This procedure is not payable unless appropriate non-p… |
CO | 4 | View → |
| AMBV | CLAIM HAS BEEN MISDIRECTED FOR NON-EMERGENCY AMBULANCE SERVICES. | — | CO | 109 | View → |
| AMID | MISSING OR INVALID MEDICAID ID FOR ATTENDING PROVIDER BILLED | — | CO | 256 | View → |
| ANE | Emergent Services billed but emergency indicator not checked. Please resubmit claim with IHCP comp… |
N272
Missing/incomplete/invalid other payer attending provi… |
CO | 16 | View → |
| AO | PROCEDURE IS AN ADD-ON CODE AND MUST BE BILLED WITH THE PRIMARY PROCEDURE. |
N122
Add-on code cannot be billed by itself. |
CO | 16 | View → |
| AP | APPEAL REVIEWED, NO FURTHER BENEFIT PAYABLE | — | CO | 193 | View → |
| AP2 | SECOND LEVEL CLAIM APPEAL REVIEWED - DENIAL IS UPHELD | — | CO | 193 | View → |
| APD | APPEAL DENIED - NO AUTHORIZATION RECEIVED. | — | CO | 138 | View → |
| APNF | Attending Provider Not Found |
N253
Missing/incomplete/invalid attending provider primary … |
CO | 206 | View → |
| APP | Non-Emergency Transportation or Transportation Service unrelated to pregnancy are not covered servi… | — | CO | 204 | View → |
| APPA | APPEAL HAS BEEN RECEIVED AND REVIEWED. ADDITIONAL PAYMENT IS WARRANTED. | — | CO | 59 | View → |
| APR | APPEAL RECEIVED - CLAIM REPROCESSED. | — | CO | 169 | View → |
| APRE | ADJUSTMENT MADE TO ALLOWED AMOUNT TO DEDUCT PAYMENT MADE ON PRIOR CLAIM FOR OTHER E/M CODE WHICH IS… |
N432
Alert: Adjustment based on a Recovery Audit. |
CO | 144 | View → |
| AR | APPEAL DENIED. AUTHORIZATION REQUESTED FROM DCHP AFTER SERVICES RENDERED. | — | CO | 193 | View → |
| AS | APPEAL DENIED, SERVICES NOT ELIGIBLE FOR REIMBURSEMENT. | — | CO | 193 | View → |
| ASNC | ASSISTANT SURGEON SERVICES NOT COVERED FOR THIS PROVIDER TYPE. | — | CO | 54 | View → |
| ASRD | PRE - AUTHORIZATION REQUIRED |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 197 | View → |
| AUT | MEMBER EXCEEDS AGE LIMIT FOR TREATMENT OF THIS CONDITION |
N129
Not eligible due to the patient's age. |
CO | 6 | View → |
| AX | SERVICE RENDERED PRIOR TO/AFTER AUTHORIZATION EFFECTIVE AND EXPIRATION DATES. | — | CO | 197 | View → |
| B1 | NON-COVERED VISITS. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | B1 | View → |
| B10 | ALLOWED AMOUNT HAS BEEN REDUCED BECAUSE A COMPONENT OF THE BASIC PROCEDURE/TEST WAS PAID. THE BENEF… | N14 | CO | B10 | View → |
| B11 | THE CLAIM/SERVICE HAS BEEN TRANSFERRED TO THE PROPER PAYER/PROCESSOR FOR PROCESSING. CLAIM/SERVICE … |
N418
Misrouted claim. See the payer's claim submission ins… |
CO | B11 | View → |
| B12 | SERVICES NOT DOCUMENTED IN PATIENTS' MEDICAL RECORDS. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | B12 | View → |
| B12D | CBC TEST RESULTS PERFORMED WITHIN THE PAST 30 DAYS MUST BE ATTACHED TO THE CLAIM WHEN CHARGES ARE S… |
M30
Missing pathology report. |
CO | 163 | View → |
| B13 | PREVIOUSLY PAID. PAYMENT FOR THIS CLAIM/SERVICE MAY HAVE BEEN PROVIDED IN A PREVIOUS PAYMENT. |
N111
No appeal right except duplicate claim/service issue. … |
CO | B13 | View → |
| B14 | ONLY ONE VISIT OR CONSULTATION PER PHYSICIAN PER DAY IS COVERED. |
N362
The number of Days or Units of Service exceeds our acc… |
CO | B14 | View → |
| B15 | THIS SERVICE/PROCEDURE REQUIRES THAT A QUALIFYING SERVICE/PROCEDURE BE RECEIVED AND COVERED. THE QU… |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | B15 | View → |
| B16 | NEW PATIENT' QUALIFICATIONS WERE NOT MET. |
N30
Patient ineligible for this service. |
CO | B16 | View → |
| B20 | PROCEDURE/SERVICE WAS PARTIALLY OR FULLY FURNISHED BY ANOTHER PROVIDER. |
N472
Payment for this service has been issued to another pr… |
CO | B20 | View → |
| B22 | THIS PAYMENT IS ADJUSTED BASED ON THE DIAGNOSIS. |
N432
Alert: Adjustment based on a Recovery Audit. |
CO | B22 | View → |
| B23 | PROCEDURE BILLED IS NOT AUTHORIZED PER YOUR CLINICAL LABORATORY IMPROVEMENT AMENDMENT (CLIA) PROFIC… |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | B23 | View → |
| B4 | LATE FILING PENALTY. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | B4 | View → |
| B5 | COVERAGE/PROGRAM GUIDELINES WERE NOT MET OR WERE EXCEEDED. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 272 | View → |
| B7 | THIS PROVIDER WAS NOT CERTIFIED/ELIGIBLE TO BE PAID FOR THIS PROCEDURE/SERVICE ON THIS DATE OF SERV… |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | B7 | View → |
Remark Codes (RARC) are used on the 835 ERA and paper EOB to provide supplemental information about a claim adjustment. They always accompany a CARC (denial code) and clarify the reason for payment differences.
A Denial Code (CARC) explains why payment was adjusted. A Remark Code (RARC) provides additional context or instructions. Both appear together on remittance — look for the CARC first, then the RARC for detail.
Search by code number or keyword, or filter by adjustment group (CO, PR, OA…). Click any code to see its full RA835 mapping, common causes, step-by-step resolution guide, and appeal tips.