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 | |
|---|---|---|---|---|---|
| 170 | PAYMENT IS DENIED WHEN PERFORMED/BILLED BY THIS TYPE OF PROVIDER. |
N95
This provider type/provider specialty may not bill thi… |
CO | 170 | View → |
| 171 | PAYMENT IS DENIED WHEN PERFORMED/BILLED BY THIS TYPE OF PROVIDER IN THIS TYPE OF FACILITY. |
N95
This provider type/provider specialty may not bill thi… |
CO | 171 | View → |
| 172 | PAYMENT IS ADJUSTED WHEN PERFORMED/BILLED BY A PROVIDER OF THIS SPECIALTY | — | CO | 172 | View → |
| 173 | SERVICE WAS NOT PRESCRIBED BY A PHYSICIAN. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 173 | View → |
| 174 | SERVICE WAS NOT PRESCRIBED PRIOR TO DELIVERY. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 174 | View → |
| 175 | PRESCRIPTION IS INCOMPLETE. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 175 | View → |
| 176 | PRESCRIPTION IS NOT CURRENT. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 176 | View → |
| 177 | PATIENT HAS NOT MET THE REQUIRED ELIGIBILITY REQUIREMENTS. |
N30
Patient ineligible for this service. |
CO | 177 | View → |
| 178 | PATIENT HAS NOT MET THE REQUIRED SPEND DOWN REQUIREMENTS. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 178 | View → |
| 179 | PATIENT HAS NOT MET THE REQUIRED WAITING REQUIREMENTS. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 179 | View → |
| 180 | PATIENT HAS NOT MET THE REQUIRED RESIDENCY REQUIREMENTS. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 180 | View → |
| 180D | APPEAL DENIED. APPEAL RECEIVED MORE THAN 180 DAYS FROM DATE OF PAYMENT OR DENIAL. | — | CO | 138 | View → |
| 181 | PROCEDURE CODE WAS INVALID ON THE DATE OF SERVICE. IN ORDER FOR THIS CLAIM TO BE RECONSIDERED ALL … |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 181 | View → |
| 183 | THE REFERRING PROVIDER IS NOT ELIGIBLE TO REFER THE SERVICE BILLED. |
N95
This provider type/provider specialty may not bill thi… |
CO | 183 | View → |
| 184 | THE PRESCRIBING/ORDERING PROVIDER IS NOT ELIGIBLE TO PRESCRIBE/ORDER THE SERVICE BILLED. |
N95
This provider type/provider specialty may not bill thi… |
CO | 184 | View → |
| 185 | THE RENDERING PROVIDER IS NOT ELIGIBLE TO PERFORM THE SERVICE BILLED. |
N95
This provider type/provider specialty may not bill thi… |
CO | 185 | View → |
| 186 | LEVEL OF CARE CHANGE ADJUSTMENT. | — | CO | 186 | View → |
| 188 | THIS PRODUCT/PROCEDURE IS ONLY COVERED WHEN USED ACCORDING TO FDA RECOMMENDATIONS. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 188 | View → |
| 189 | NOT OTHERWISE CLASSIFIED' OR 'UNLISTED' PROCEDURE CODE (CPT/HCPCS) WAS BILLED WHEN THERE IS A SPECI… |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 189 | View → |
| 190 | PAYMENT IS INCLUDED IN THE ALLOWANCE FOR A SKILLED NURSING FACILITY (SNF) QUALIFIED STAY. |
N19
Procedure code incidental to primary procedure. |
CO | 190 | View → |
| 193 | ORIGINAL PAYMENT DECISION IS BEING MAINTAINED. UPON REVIEW, IT WAS DETERMINED THAT THIS CLAIM WAS P… |
MA46
Alert: The new information was considered but addition… |
CO | 193 | View → |
| 194 | ANESTHESIA PERFORMED BY THE OPERATING PHYSICIAN, THE ASSISTANT SURGEON OR THE ATTENDING PHYSICIAN. | — | CO | 194 | View → |
| 197 | PRECERTIFICATION/AUTHORIZATION/NOTIFICATION ABSENT. |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 197 | View → |
| 198 | PRECERTIFICATION/AUTHORIZATION EXCEEDED. |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 197 | View → |
| 199 | REVENUE CODE AND PROCEDURE CODE DO NOT MATCH. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 199 | View → |
| 200D | DME SERVICE EXCEEDS QUANTITY LIMITS. SVC LIMITED TO 200 EVERY 30 DAYS. |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 222 | View → |
| 200U | SERVICES EXCEEDING 200 UNITS PER MEMBER/PER PROVIDER REQUIRE AUTHORIZATION |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 197 | View → |
| 203 | DISCONTINUED OR REDUCED SERVICE. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 203 | View → |
| 206 | NATIONAL PROVIDER IDENTIFIER - MISSING. |
N95
This provider type/provider specialty may not bill thi… |
CO | 206 | View → |
| 207 | NATIONAL PROVIDER IDENTIFIER - INVALID FORMAT |
N95
This provider type/provider specialty may not bill thi… |
CO | 207 | View → |
| 208 | NATIONAL PROVIDER IDENTIFIER - NOT MATCHED. |
N95
This provider type/provider specialty may not bill thi… |
CO | 208 | View → |
| 209 | PER REGULATORY OR OTHER AGREEMENT. THE PROVIDER CANNOT COLLECT THIS AMOUNT FROM THE PATIENT. HOWEVE… | — | CO | 45 | View → |
| 210 | PAYMENT ADJUSTED BECAUSE PRE-CERTIFICATION/AUTHORIZATION NOT RECEIVED IN A TIMELY FASHION |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 210 | View → |
| 211 | NATIONAL DRUG CODES (NDC) NOT ELIGIBLE FOR REBATE, ARE NOT COVERED. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 211 | View → |
| 212 | ADMINISTRATIVE SURCHARGES ARE NOT COVERED |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 212 | View → |
| 213 | NON-COMPLIANCE WITH THE PHYSICIAN SELF REFERRAL PROHIBITION LEGISLATION OR PAYER POLICY. |
N475
Missing completed referral form. |
CO | 213 | View → |
| 216 | BASED ON THE FINDINGS OF A REVIEW ORGANIZATION | — | CO | 216 | View → |
| 231 | MUTUALLY EXCLUSIVE PROCEDURES CANNOT BE DONE IN THE SAME DAY/SETTING. | — | CO | 231 | View → |
| 245 | PROVIDER NOT ELIGIBLE TO RECEIVE PAYMENT PER HFS OIG GUIDANCE. | — | CO | 245 | View → |
| 300L | DME SERVICE EXCEEDS QUANTITY LIMITS. SVC LIMITED TO 300 EVERY 30 DAYS. |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 222 | View → |
| 800U | SERVICES EXCEEDING 800 UNITS PER MEMBER/PER PROVIDER REQUIRE PRE-AUTHORIZATION. |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 197 | View → |
| 837 | CLAIM HAS BEEN REPROCESSED FOR SYSTEM RECONCILIATION, NOT IN RESPONSE TO INQUIRY OR RESUBMISSION BY… |
N377
Payment based on a processed replacement claim. |
CO | B13 | View → |
| 2014 | MUE-MEDICAID FAC- HCPCS UNITS FOR LINE ITEM EXCEED MEDICALLY UNLIKELY EDIT MAXIMUM OF XX. APPROPRI… |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 96 | View → |
| 2020 | FAC MUE-HPCPS LINE ITEM UNITS EXCEED MEDICALLY UNLIKELY EDIT MAXIMUM OF XX. |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 96 | View → |
| 2030 | FAC MUE-HCPCS TOTAL UNITS EXCEED DAILY ALLOWED MEDICALLY UNLIKELY EDIT MAXIUM OF XX CONTRARY TO CMS… |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 96 | View → |
| 2040 | FAC MUE- HCPCS TOTAL UNITS EXCEED DAILY ALLOWED MEDICALLY UNLIKELY EDIT MAXIMUM OF XX BASED ON CLIN… |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 96 | View → |
| 2220 | MUE-MEDICAID FAC- PROCEDURE CODE PAIR CONFLICT WITH 'XXXXX' AND IS NOT ALLOWED EVEN IF APPROPRIATE … |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 16 | View → |
| 2240 | NCCI MEDICAID FAC- PROCEDURE CODE PAIR CONFLICT WITH 'XXXXX' AND IS ALLOWED IF AN APPROPRIATE NCCI … |
N519
Invalid combination of HCPCS modifiers. |
CO | 16 | View → |
| 3005 | EAPG-EXTERNAL CAUSE OF MORBIDITY CODE CANNOT BE USED AS PRIMARY OR PRINCIPAL DIAGNOSIS. |
MA63
Missing/incomplete/invalid principal diagnosis. |
CO | 16 | View → |
| 3006 | EAPG-INVALID PROCEDURE CODE. |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 16 | 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.