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 | |
|---|---|---|---|---|---|
| US2 | SERVICES ARE LIMITED TO 2 OBSTETRIC ULTRASOUNDS PER PREGNANCY. |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 222 | View → |
| VAC | VACCINE AND ADMIN CODE MUST BE BILLED TOGETHER |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 16 | View → |
| VBID | COST SHARING WAIVED DUE TO CHRONIC ILLNESS SUPPORT PROGRAM. | — | CO | 59 | View → |
| VDOS | PLEASE VERIFY DATE OF SERVICE WAS BILLED CORRECTLY VERSES ALL OTHER DATES OF SERVICE BILLED. |
N65
Procedure code or procedure rate count cannot be deter… |
CO | 16 | View → |
| VIRT | G2012 MUST BE BILLED SEPARATELY FROM ENCOUNTER CODE |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 272 | View → |
| VIS1 | ONE EYE EXAM PER YEAR. |
N640
Exceeds number/frequency approved/allowed within time … |
CO | 222 | View → |
| VIS2 | ONE EYE EXAM EVERY 2 YEARS |
N640
Exceeds number/frequency approved/allowed within time … |
CO | 222 | View → |
| VNC | VISION IS NOT A COVERED BENEFIT. |
N216
We do not offer coverage for this type of service or t… |
CO | 96 | View → |
| VSHD | VISION HARDWARE IS NOT SEPARATELY PAYABLE. |
N330
Missing/incomplete/invalid patient death date. |
CO | 97 | View → |
| VSP | SERVICES SHOULD BE SUBMITTED TO THE VISION VENDOR FOR CONSIDERATION. | — | CO | 109 | View → |
| WATY | CLAIM DOES NOT FOLLOW HFS ATYPICAL BILLING GUIDELINES |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 272 | View → |
| WC3Y | SERVICES EXCEEDING 3 VISITS PER YEAR REQUIRE AUTHORIZATION |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 197 | View → |
| WCYM | PRIOR AUTH REQUIRED WHEN SERVICES EXCEEDS 3 VISITS PER YEAR. |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 197 | View → |
| WH | WITHHOLD - 19% | — | CO | 104 | View → |
| WNC | WAIVER SERVICES NOT COVERED UNDER BENEFIT PLAN. |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 204 | View → |
| WRED | 25% WITHOLD REDUCTION APPLIES | — | CO | 45 | View → |
| WTAK | 25% WITHHOLD DEDUCTION TAKEN ON CLAIM | — | CO | 45 | View → |
| WVPD | Member Not Eligible for 1115 Waiver Program Benefit |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 96 | View → |
| X1 | ADMISSION DIAGNOSIS: THE ADMISSION DIAGNOSIS IS INVALID OR DISABLED. |
MA65
Missing/incomplete/invalid admitting diagnosis. |
CO | 16 | View → |
| X10 | ADMISSION DIAGNOSIS IS NOT TYPICAL FOR A PATIENT OF THIS AGE. |
M76
Missing/incomplete/invalid diagnosis or condition. |
CO | 9 | View → |
| X100 | E/M CONDITION NOT MET AND LINE ITEM DATE FOR OBS CODE G0244 IS NOT 12/31 OR 1/1 |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 16 | View → |
| X101 | COMPOSITE E/M CONDITION NOT MET FOR OBSERVATION AND LINE ITEM DATE FOR CODE G0378 IS 1/1 |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 272 | View → |
| X102 | G0379 ONLY ALLOWED WITH G0378 |
M15
Separately billed services/tests have been bundled as … |
CO | 234 | View → |
| X103 | CLINICAL TRIAL REQUIRES DIAGNOSIS CODE V707 AS OTHER THAN PRIMARY DIAGNOSIS |
M76
Missing/incomplete/invalid diagnosis or condition. |
CO | 16 | View → |
| X104 | USE OF MODIFIER CA WITH MORE THAN ONE PROCEDURE NOT ALLOWED |
N519
Invalid combination of HCPCS modifiers. |
CO | 16 | View → |
| X105 | SERVICE CAN ONLY BE BILLED TO THE DMERC |
N255
Missing/incomplete/invalid billing provider taxonomy. |
CO | 16 | View → |
| X106 | CODE NOT RECOGNIZED BY OPPS; ALTERNATE CODE FOR SAME SERVICE MAY BE AVAILABLE |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 16 | View → |
| X107 | THIS OT CODE ONLY BILLED ON PARTIAL HOSPITALIZATION CLAIMS |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 16 | View → |
| X108 | AT SERVICE NOT PAYABLE OUTSIDE THE PARTIAL HOSPITALIZATION PROGRAM |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 16 | View → |
| X109 | REVENUE CODE NOT RECOGNIZED BY MEDICARE |
M50
Missing/incomplete/invalid revenue code(s). |
CO | 16 | View → |
| X11 | PRINCIPAL DIAGNOSIS IS NOT TYPICAL FOR A PATIENT OF THIS AGE. |
N129
Not eligible due to the patient's age. |
CO | 6 | View → |
| X110 | CODE REQUIRES MANUAL PRICING |
N10
Adjustment based on the findings of a review organizat… |
CO | 144 | View → |
| X111 | SERVICE PROVIDED PRIOR TO FDA APPROVAL | — | CO | 188 | View → |
| X112 | SERVICE PROVIDED PRIOR TO DATE OF NATIONAL COVERAGE DETERMINATION (NCD) APPROVAL |
N386
This decision was based on a National Coverage Determi… |
CO | 96 | View → |
| X113 | SERVICE PROVIDED OUTSIDE APPROVAL PERIOD |
N351
Service date outside of the approved treatment plan se… |
CO | 96 | View → |
| X114 | CA MODIFIER REQUIRES PATIENT STATUS CODE 20 |
N657
This should be billed with the appropriate code for th… |
CO | 16 | View → |
| X115 | CLAIM LACKS REQUIRED DEVICE CODE |
N657
This should be billed with the appropriate code for th… |
CO | 16 | View → |
| X116 | SERVICE NOT BILLABLE TO THE FISCAL INTERMEDIARY/MEDICARE ADMINISTRATIVE CONTRACTOR |
N479
Missing Explanation of Benefits (Coordination of Benef… |
CO | 163 | View → |
| X117 | INCORRECT BILLING OF BLOOD AND BLOOD PRODUCTS |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 16 | View → |
| X118 | UNITS GREATER THAN ONE FOR BILATERAL PROCEDURE BILLED WITH MODIFIER 50 |
N644
Reimbursement has been made according to the bilateral… |
CO | 59 | View → |
| X119 | INCORRECT BILLING OF MODIFIER FB OR FC |
N572
This procedure is not payable unless appropriate non-p… |
CO | 16 | View → |
| X12 | OTHER DIAGNOSIS IS NOT TYPICAL FOR A PATIENT OF THIS AGE. |
N129
Not eligible due to the patient's age. |
CO | 9 | View → |
| X120 | TRAUMA RESPONSE CRITICAL CARE CODE WITHOUT REVENUE CODE 068X AND CPT 99291 |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 16 | View → |
| X121 | CLAIM LACKS ALLOWED PROCEDURE CODE |
M20
Missing/incomplete/invalid HCPCS. |
CO | 16 | View → |
| X122 | CLAIM LACKS REQUIRED RADIOLABELED PRODUCT |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 16 | View → |
| X123 | INCORRECT BILLING OF REVENUE CODE WITH HCPCS CODE |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 199 | View → |
| X124 | MENTAL HEALTH CODE NOT APPROVED FOR PARTIAL HOSPITALIZATION | — | CO | 96 | View → |
| X125 | MENTAL HEALTH SERVICE NOT PAYABLE OUTSIDE THE PARTIAL HOSPITALIZATION PROGRAM | — | CO | 96 | View → |
| X126 | CHARGE EXCEEDS TOKEN CHARGE ($1.01) |
N640
Exceeds number/frequency approved/allowed within time … |
CO | 119 | View → |
| X127 | SERVICE PROVIDED ON OR AFTER EFFECTIVE DATE OF NCD NON-COVERAGE |
N30
Patient ineligible for this service. |
CO | 27 | 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.