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 | |
|---|---|---|---|---|---|
| 3P6 | SERVICE IS LIMITED TO 3 TIMES WITHIN A 6 MONTH PERIOD. |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 222 | View → |
| 04EA | EAPG CLAIM NOT PROCESSED; CLAIM HAS NO VALID VISITS. |
M53
Missing/incomplete/invalid days or units of service. |
CO | 16 | View → |
| 4U | SERVICES EXCEEDING 4 UNITS PER DAY REQUIRE PRE-AUTHORIZATION. |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 197 | View → |
| 4UDM | PRIOR AUTHORIZATION REQUIRED FOR SERVICES EXCEEDING 4 UNITS PER DAY. |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 197 | View → |
| 05EA | EAPG CLAIM NOT PROCESSED; NO PRIMARY DIAGOSNIS CODE. |
M76
Missing/incomplete/invalid diagnosis or condition. |
CO | 16 | View → |
| 5 | THE PROCEDURE CODE/BILL TYPE IS INCONSISTENT WITH THE PLACE OF SERVICE. |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 5 | View → |
| 6 | THE PROCEDURE/REVENUE CODE IS INCONSISTANT WITH THE PATIENT'S AGE. |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 6 | View → |
| 7 | THE PROCEDURE/REVENUE CODE IS INCONSISTENT WITH THE PATIENT'S GENDER. |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 7 | View → |
| 8 | THE PROCEDURE CODES IS INCONSISTENT WITH THE PROVIDER TYPE/SPECIALTY (TAXONOMY). |
N255
Missing/incomplete/invalid billing provider taxonomy. |
CO | 8 | View → |
| 9 | THE DIAGNOSIS IS INCONSISTENT WITH THE PATIENT'S AGE. |
M64
Missing/incomplete/invalid other diagnosis. |
CO | 9 | View → |
| 10 | THE DIAGNOSIS IS INCONSISTENT WITH THE PATIENT'S GENDER. |
M64
Missing/incomplete/invalid other diagnosis. |
CO | 10 | View → |
| 10CC | CRITICAL CARE IS LIMITED TO 10 VISITS PER CONFINEMENT. |
N640
Exceeds number/frequency approved/allowed within time … |
CO | 222 | View → |
| 11 | THE DIAGNOSIS IS INCONSISTENT WITH THE PROCEDURE. |
M64
Missing/incomplete/invalid other diagnosis. |
CO | 11 | View → |
| 12 | THE DIAGNOSIS IS INCONSISTENT WITH THE PROVIDER TYPE. |
M64
Missing/incomplete/invalid other diagnosis. |
CO | 12 | View → |
| 14RH | SERVICES ARE LIMITED TO 14 DAYS OF INPATIENT RESPITE CARE ANNUALLY. |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 222 | View → |
| 15 | THE AUTHORIZATION NUMBER IS MISSING, INVALID, OR DOES NOT APPLY TO THE BILLED SERVICES OR PROVIDER. |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 15 | View → |
| 16 | CLAIM/SERVICE LACKS INFORMATION WHICH IS NEEDED FOR ADJUDICATION. AT LEAST ONE REMARK CODE MUST BE… |
N517
Resubmit a new claim with the requested information. |
CO | 16 | View → |
| 18 | DUPLICATE CLAIM/SERVICE. |
M86
Service denied because payment already made for same/s… |
CO | 97 | View → |
| 19 | THIS IS A WORK-RELATED INJURY/ILLNESS AND THUS THE LIABILITY OF THE WORKER'S COMPENSATION CARRIER. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 19 | View → |
| 20 | THIS INJURY/ILLNESS IS COVERED BY THE LIABILITY CARRIER. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 20 | View → |
| 20CC | CRITICAL CARE IS LIMITED TO 20 VISITS PER CONFINEMENT. |
N640
Exceeds number/frequency approved/allowed within time … |
CO | 222 | View → |
| 20LM | UNITS EXCEEDING 200 UNITS REQUIRES PA PER MEMBER PER PROVIDER |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 197 | View → |
| 21 | THIS INJURY/ILLNESS IS THE LIABILITY OF THE NO-FAULT CARRIER. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 21 | View → |
| 22 | THIS CARE MAY BE COVERED BY ANOTHER PAYER PER COORDINATION OF BENEFITS. |
N23
Alert: Patient liability may be affected due to coordi… |
CO | 22 | View → |
| 23 | THE IMPACT OF PRIOR PAYER(S) ADJUDICATION INCLUDING PAYMENTS AND/OR ADJUSTMENTS. |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 96 | View → |
| 24 | CHARGES ARE COVERED UNDER A CAPITATION AGREEMENT/MANAGED CARE PLAN. |
M87
Claim/service(s) subjected to CFO-CAP prepayment revie… |
CO | 24 | View → |
| 29 | THE TIME LIMIT FOR FILING HAS EXPIRED. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 29 | View → |
| 30 | INFO NOT REC'D WITHIN 30 DAYS, PATIENT NOT RESPONSIBLE |
N432
Alert: Adjustment based on a Recovery Audit. |
CO | 226 | View → |
| 39 | SERVICES DENIED AT THE TIME AUTHORIZATION/PRE-CERTIFICATION WAS REQUESTED. |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 39 | View → |
| 40 | CHARGES DO NOT MEET QUALIFICATIONS FOR EMERGENT/URGENT CARE. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 40 | View → |
| 44 | PROMPT-PAY DISCOUNT. | — | CO | 44 | View → |
| 45 | CHARGE EXCEEDS FEE SCHEDULE/MAXIMUM ALLOWABLE OR CONTRACTED/LEGISLATED FEE ARRANGEMENT. (USE GROUP … |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 45 | View → |
| 49 | THESE ARE NON-COVERED SERVICES BECAUSE THIS IS A ROUTINE EXAM OR SCREENING PROCEDURE DONE IN CONJUN… |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 49 | View → |
| 54 | MULTIPLE PHYSICIANS/ASSISTANTS ARE NOT COVERED IN THIS CASE . |
N95
This provider type/provider specialty may not bill thi… |
CO | 54 | View → |
| 55EA | EAPG CLAIM LINE ACTION- NO PAYMENT. INVALID PROCEDURE, CANNOT BE BLANK OR NO EAPG REIMBURSEMENT FOR… |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 16 | View → |
| 58 | TREATMENT WAS DEEMED BY THE PAYER TO HAVE BEEN RENDERED IN AN INAPPROPRIATE OR INVALID PLACE OF SER… |
M77
Missing/incomplete/invalid/inappropriate place of serv… |
CO | 58 | View → |
| 59 | PROCESSED BASED ON MULTIPLE OR CONCURRENT PROCEDURE RULES. (FOR EXAMPLE MULTIPLE SURGERY OR DIAGNOS… | N14 | CO | 59 | View → |
| 60 | CHARGES FOR OUTPATIENT SERVICES ARE NOT COVERED WHEN PERFORMED WITHIN A PERIOD OF TIME PRIOR TO OR … |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 60 | View → |
| 60D | APPEAL DENIED. APPEAL RECEIVED MORE THAN 60 DAYS FROM DATE OF PAYMENT OR DENIAL | — | CO | 193 | View → |
| 65D | APPEAL DENIED. APPEAL RECEIVED MORE THAN 65 DAYS FROM DATE OF PAYMENT OR DENIAL | — | CO | 164 | View → |
| 69 | DAY OUTLIER AMOUNT. | — | CO | 69 | View → |
| 70 | COST OUTLIER - ADJUSTMENT TO COMPENSATE FOR ADDITIONAL COSTS. |
N432
Alert: Adjustment based on a Recovery Audit. |
CO | 70 | View → |
| 74 | INDIRECT MEDICAL EDUCATION ADJUSTMENT. | N14 | CO | 74 | View → |
| 75 | DIRECT MEDICAL EDUCATION ADJUSTMENT. | N14 | CO | 75 | View → |
| 76 | DISPROPORTIONATE SHARE ADJUSTMENT. | N14 | CO | 76 | View → |
| 78 | NON-COVERED DAYS/ROOM CHARGE ADJUSTMENT. | N14 | CO | 78 | View → |
| 80LM | SERVICES EXCEEDING 800 UNITS PER MEMBER PER PROVIDER REQUIRE PRE AUTH. |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 197 | View → |
| 89 | PROFESSIONAL FEES REMOVED FROM CHARGES. | — | CO | 89 | View → |
| 90 | NON-TIMELY FILED CLAIM, PATIENT NOT RESPONSIBLE. | — | CO | 29 | View → |
| 90C | DENIED DUE TO NON-TIMELY FILING OF A CORRECTED CLAIM - PLEASE REFERENCE COUNTYCARE BILLING MANUAL" | — | CO | 29 | 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.