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 | |
|---|---|---|---|---|---|
| Y378 | EAPG- Injection is coded. Ensure that the substance injected is also coded. |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y379 | EAPG- Lens implant is coded. Ensure that the intraocular lens is also coded if applicable. |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y38 | PROCEDURE CODE IS NON-COVERED. |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 96 | View → |
| Y380 | EAPG- Neurostimulator implantation is coded. Ensure that the neurostimulator is also coded. |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y381 | EAPG- Insertion of prosthesis is coded. Ensure that the penile prosthesis is also coded. |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y382 | EAPG- Radiology procedure with contrast is coded. Ensure that the contrast material is also coded. |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y383 | EAPG- Interventional radiology procedure is coded. Ensure that the surgical intervention is also co… |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y384 | EAPG- A 3D rendering radiology procedure is coded. Ensure that the base radiology procedure is also… |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y385 | EAPG- Surgical placement of device for clinical brachytherapy has been coded. Ensure that applicat… |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y386 | EAPG- Skin substitute is coded. Ensure that application of the skin substitute is also coded. |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y387 | EAPG - NCCI Medicaid FAC - Procedure code pair conflict is allowed if an appropriate NCCI modifier … |
N431
Not covered with this procedure. |
CO | 96 | View → |
| Y395 | Duplicate Claim. |
N522
Duplicate of a claim processed, or to be processed, as… |
CO | 18 | View → |
| Y397 | Procedure code was billed with more than one assistant surgeon. Only one surgical assistant is all… | — | CO | 54 | View → |
| Y4 | THE PATIENT AGE IS INVALID |
N329
Missing/incomplete/invalid patient birth date. |
CO | 16 | View → |
| Y402 | T1015 procedure code must be billed as the first procedure code on the claim. |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 96 | View → |
| Y403 | Claim does not contain the appropriate ER, observation or psychiatric clinic services for Illinois … |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 96 | View → |
| Y41 | ICD-10: PROCEDURE CODE IS LIMITED COVERAGE OR IS ASSOCIATED WITH A LIMITED COVERAGE DIAGNOSIS CODE … |
N657
This should be billed with the appropriate code for th… |
CO | 11 | View → |
| Y42 | THE PROCEDURE CODE SHOULD NOT BE REPORTED WHEN THE PATIENTâS LENGTH OF STAY IS LESS THAN FOUR DAY… |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 96 | View → |
| Y448 | (Physician/Ancillary)Per Medicaid's Medically Unlikely Edits Policy, total units billed for procedu… |
M53
Missing/incomplete/invalid days or units of service. |
CO | 222 | View → |
| Y449 | (Outpatient)Per Medicaid's Medically Unlikely Edits Policy, total units billed for procedure exceed… |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 222 | View → |
| Y450 | Physician/Ancillary)Per Medicaid's CCI Guidelines, Procedure Code has an unbundle relationship with… |
M15
Separately billed services/tests have been bundled as … |
CO | 234 | View → |
| Y451 | (Physician/Ancillary)Per Medicaid's CCI Guidelines, History Procedure Code on Claim has an unbundle… |
M15
Separately billed services/tests have been bundled as … |
CO | 234 | View → |
| Y452 | (Outpatient)Per Medicaid's CCI Guidelines, Procedure Code has an unbundle relationship with another… |
M15
Separately billed services/tests have been bundled as … |
CO | 234 | View → |
| Y453 | (Outpatient)Per Medicaid's CCI Guidelines, History Procedure Code has an unbundle relationship with… |
M15
Separately billed services/tests have been bundled as … |
CO | 234 | View → |
| Y455 | IL MCD emergency contraceptive pills must be billed using J8499 effective with dates of service Jun… |
M119
Missing/incomplete/invalid/ deactivated/withdrawn Nati… |
CO | 96 | View → |
| Y456 | Service is not payable under the FQHC encounter rate. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 96 | View → |
| Y468 | NDC billed is not in the proper format. The NDC must be in the 5-4-2 configuration. (line level de… |
M119
Missing/incomplete/invalid/ deactivated/withdrawn Nati… |
CO | 16 | View → |
| Y469 | NDC billed is not in the proper format. The NDC must be in the 5-4-2 configuration. (claim level d… |
M119
Missing/incomplete/invalid/ deactivated/withdrawn Nati… |
CO | 16 | View → |
| Y471 | Procedure code requires that an NDC must be billed according to NDC billing guidelines. (claim leve… |
N657
This should be billed with the appropriate code for th… |
CO | 16 | View → |
| Y472 | S5190 is for reporting purposes only and is not payable. | — | CO | 246 | View → |
| Y474 | Place of service is illogical. |
M77
Missing/incomplete/invalid/inappropriate place of serv… |
CO | 16 | View → |
| Y475 | Long Acting Reversible Contraception (LARC) must be billed separately from the encounter. |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 96 | View → |
| Y499 | INSTITUTIONAL CLAIM WAS REGROUPED BASED ON POLICY. FINAL APR-DRG WAS CHANGED. | — | CO | 45 | View → |
| Y5 | THE PATIENT SEX IS INVALID |
MA39
Missing/incomplete/invalid gender. |
CO | 16 | View → |
| Y500 | DIAGNOSTIC/THERAPEUTIC IMAGING RADIOPHARMACEUTICAL / CONTRAST AGENT LINK IS NOT COVERED BY MEDICARE… |
N657
This should be billed with the appropriate code for th… |
CO | 16 | View → |
| Y508 | Drug unit qualifier (unit of measure) is missing or invalid |
M123
Missing/incomplete/invalid name, strength, or dosage o… |
CO | 16 | View → |
| Y517 | Possible improper billing of Accute Kidney Injury claim (Eff. 1/1/2017) |
N657
This should be billed with the appropriate code for th… |
CO | 16 | View → |
| Y518 | Revenue code is no longer valid for this service, please rebill with correct H code. |
M50
Missing/incomplete/invalid revenue code(s). |
CO | 16 | View → |
| Y519 | Place of service is missing or not valid. |
M77
Missing/incomplete/invalid/inappropriate place of serv… |
CO | 16 | View → |
| Y520 | Procedure code must be billed with Place of Service 55. |
M77
Missing/incomplete/invalid/inappropriate place of serv… |
CO | 16 | View → |
| Y521 | Series Bill Revenue Code Required |
M50
Missing/incomplete/invalid revenue code(s). |
CO | 16 | View → |
| Y539 | Inpatient Principal Hospital Acquired Condition | — | CO | 233 | View → |
| Y540 | Inpatient Other Hospital Acquired Condition | — | CO | 233 | View → |
| Y546 | THIS LINE ITEM CONFLICTS WITH CCI EDIT POLICY. | — | CO | 16 | View → |
| Y547 | DME CODE BILLED WITH INVALID MODIFIER. |
N572
This procedure is not payable unless appropriate non-p… |
CO | 4 | View → |
| Y548 | PAYMENT FOR DISCONTINUED PROCEDURES IS BASED ON PERCENTAGE OF SERVICE COMPLETED. PLEASE SUBMIT MED… |
N204
Services under review for possible pre-existing condit… |
CO | 163 | View → |
| Y549 | AB CODE IS PART OF AN AUTOMATED PANEL. REIMBURSEMENT IS A PERCENTAGE OF MPFS ALLOWABLE. |
N381
Alert: Consult our contractual agreement for restricti… |
CO | 144 | View → |
| Y550 | FX MODIFIER (FILM XRAY) HAS A 20% REDUCTION OF THE TC (AND THE TC OF THE GLOABEL FEE) EFFECTIVE 1/1… |
N546
Payment represents a previous reduction based on the E… |
CO | 45 | View → |
| Y551 | THIS IS A DUPLICATE LINE ITEM |
N111
No appeal right except duplicate claim/service issue. … |
CO | 18 | View → |
| Y552 | SUPPLIES FURNISHED BY COMPREHENSIVE OUTPATIENT REHABILITATION FACILITIES (CORFS) OR OUTPATIENT PHYS… |
M15
Separately billed services/tests have been bundled as … |
CO | 97 | 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.