Remark Codes — Complete List & Lookup

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.

2,992

Total Remark Codes

Adjustment Groups

835

RA835 Mapped

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Looking for Denial Codes (CARC)?

Browse Claim Adjustment Reason Codes — the codes that explain why a payment was reduced or denied.

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Showing 101–150 of 172 remark codes in group OA

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Remark Code	Description	RA835 Code	Group	Reason Code
NAMB	CLAIM SUBMITTED NOT FOLLOWING TRANSPORTATION GUIDELINES AS DEFINED BY HFS.	—	OA	272	View →
NCN	RENDERING PROVIDER IS NOT ELIGIBLE TO PERFORM THE BILLED SERVICE.	N95 This provider type/provider specialty may not bill thi…	OA	170	View →
NCTX	SERVICES BY THIS PROVIDER TYPE ARE NOT COVERED UNDER THE PLAN.	N95 This provider type/provider specialty may not bill thi…	OA	170	View →
OB72	OBSERVATION SERVICES CANNOT EXCEED 72HRS. ANY SERVICES ORDERED AFTER 72 HOURS OF OBSERVATION MUST …	N640 Exceeds number/frequency approved/allowed within time …	OA	119	View →
OBP	OON PURCHASE OF SUPPLY AFTER 03/01/2014 WILL GO TOWARDS YOUR OUT OF NETWORK DEDUCTIBLE/OUT OF POCKE…	—	OA	1	View →
PCID	PCID - Provider has been notified to submit completed medical records for the claim as part of a Pa…	N35 Program integrity/utilization review decision.	OA	16	View →
PDIF	Payment Integrity DRG Audit recovery/recoupment that was internally identified by the Evolent team …	N35 Program integrity/utilization review decision.	OA	16	View →
PDIP	Payment Integrity DRG Audit recovery/recoupment that was internally identified by the Evolent team …	N35 Program integrity/utilization review decision.	OA	16	View →
PGIF	Payment Integrity Clinical Audit recovery/recoupment that was internally identified by the Evolent …	N35 Program integrity/utilization review decision.	OA	16	View →
PIR	PRIMARY INSURANCE HAS REQUESTED ADDITIONAL INFORMATION BEFORE THEY DETERMINE THEIR PAYMENT.	M25 The information furnished does not substantiate the ne…	OA	16	View →
PIW	PAYMENT BEING HELD AT THE DIRECTION OF HFS	N35 Program integrity/utilization review decision.	OA	16	View →
RCOP	CLAIM HAS BEEN REPROCESSED DUE TO DEDUCTIBLE AND/OR OUT OF POCKET MET. REFUND MAY BE OWED TO PATIE…	—	OA	2	View →
RNC	RENTAL OF SUPPLY NOT ELIGIBLE. THIS SUPPLY CAN ONLY BE PURCHASED.	N174 This is not a covered service/procedure/ equipment/bed…	OA	96	View →
RORP	ALERT (ORP): Entity's National Provider Identifier (NPI). Missing or invalid information.	—	OA	206	View →
SCN	MAXIMUM BENFT EXCEEDED. SMOKING CESSATION MAXIMIMUM 12 WEEK COURSE OF TREATMENT PER MEMBER PER CALE…	N362 The number of Days or Units of Service exceeds our acc…	OA	119	View →
SDC	EXPENSES INCURRED AFTER COVERAGE TERMINATED	N30 Patient ineligible for this service.	OA	27	View →
SN90	SKILLED NURSING FACILITY LIMITED TO 90 DAYS PER CALENDER YEAR	N362 The number of Days or Units of Service exceeds our acc…	OA	222	View →
TAMB	Taxonomy not within state transportation guidelines Eff: 1/1/17	—	OA	272	View →
TCMB	Taxonomy & claim text note not within state transportation guidelines Eff: 1/1/17	—	OA	272	View →
TH1	THERAPY SERVICE LIMITED TO ONE UNIT PER DAY	N362 The number of Days or Units of Service exceeds our acc…	OA	222	View →
TH4	THERAPY SERVICE LIMITED TO FOUR UNITS PER DAY	N362 The number of Days or Units of Service exceeds our acc…	OA	222	View →
TH8	THERAPY SERVICE LIMITED TO EIGHT UNITS PER DAY	N362 The number of Days or Units of Service exceeds our acc…	OA	222	View →
VHRD	VISION HARDWARE LIMITED TO $150.00 BENEFITS ALLOWED. MEMBER MAY BE RESPONSIBLE FOR CHARGES OVER THI…	—	OA	119	View →
X56	QUESTIONABLE COVERED SERVICE	N661 Documentation does not support that the services rende…	OA	50	View →
YAMB	Y' Indicator missing from box 24C not within state transportation guidelines Eff: 1/1/17	—	OA	272	View →
ZDNF	THIS DEPENDENT UNDER AGE 1 WAS NOT FOUND IN ELIGIBILITY.	N30 Patient ineligible for this service.	OA	32	View →
ZMD	MAXIMUM DEDUCTIBLE FOR THIS TIME PERIOD HAS BEEN REACHED.	—	OA	1	View →
ZMNA	MEMBER WAS NOT ACTIVE FOR THE FULL TIME PERIOD OF THIS CLAIM	N30 Patient ineligible for this service.	OA	200	View →
ZNPW	SERVICES ARE NOT ELIGIBLE AS YOUR WAITING PERIOD HAS NOT BEEN COMPLETED	N174 This is not a covered service/procedure/ equipment/bed…	OA	96	View →
ZOOP	OUT OF POCKET FOR THIS TIME PERIOD HAS BEEN REACHED	—	OA	119	View →
ZPGP	THIS MEMBER'S ELIGIBILITY IS PAST THE GRACE PERIOD PAID THROUGH DATE	N30 Patient ineligible for this service.	OA	32	View →
1	DEDUCTIBLE AMOUNTS	—	OA	1	View →
1P24	SERVICE IS LIMITED TO ONE PER 24 MONTHS.	N362 The number of Days or Units of Service exceeds our acc…	OA	222	View →
1P6M	SERVICES ARE LIMITED TO ONE EVERY 6 MONTHS.	N362 The number of Days or Units of Service exceeds our acc…	OA	222	View →
2	COINSURANCE AMOUNT	—	OA	2	View →
3	CO-PAYMENT AMOUNT	—	OA	3	View →
4PYR	SERVICES ARE LIMITED TO 4 PER YEAR	N362 The number of Days or Units of Service exceeds our acc…	OA	222	View →
20VS	SERVICE IS LIMITED TO 20 VISITS.	N640 Exceeds number/frequency approved/allowed within time …	OA	119	View →
26	EXPENSES INCURRED PRIOR TO COVERAGE.	N30 Patient ineligible for this service.	OA	26	View →
27	EXPENSES INCURRED AFTER COVERAGE TERMINATED.	N30 Patient ineligible for this service.	OA	27	View →
31	PATIENT CANNOT BE IDENTIFIED AS OUR INSURED.	N30 Patient ineligible for this service.	OA	31	View →
32	CLAIM DENIED AS PATIENT CANNOT BE IDENTIFIED AS OUR INSURED.	N30 Patient ineligible for this service.	OA	31	View →
33	INSURED HAS NO DEPENDENT COVERAGE.	N30 Patient ineligible for this service.	OA	32	View →
34	INSURED HAS NO COVERAGE FOR NEWBORNS.	N30 Patient ineligible for this service.	OA	34	View →
35	LIFETIME BENEFIT MAXIMUM HAS BEEN REACHED.	N362 The number of Days or Units of Service exceeds our acc…	OA	35	View →
50	THESE ARE NON-COVERED SERVICES BECAUSE THIS IS NOT DEEMED A 'MEDICAL NECESSITY' BY THE PAYER.	N174 This is not a covered service/procedure/ equipment/bed…	OA	50	View →
51	THESE ARE NON-COVERED SERVICES BECAUSE THIS IS A PRE-EXISTING CONDITION	N174 This is not a covered service/procedure/ equipment/bed…	OA	51	View →
53	SERVICES BY AN IMMEDIATE RELATIVE OR A MEMBER OF THE SAME HOUSEHOLD ARE NOT COVERED.	N30 Patient ineligible for this service.	OA	53	View →
55	PROCEDURE/TREATMENT IS DEEMED EXPERIMENTAL/INVESTIGATIONAL BY THE PAYER.	N174 This is not a covered service/procedure/ equipment/bed…	OA	55	View →
56	PROCEDURE/TREATMENT HAS NOT BEEN DEEMED 'PROVEN TO BE EFFECTIVE' BY THE PAYER.	N174 This is not a covered service/procedure/ equipment/bed…	OA	56	View →

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What is a Remark Code?

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.

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Remark Code vs. Denial Code

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.

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How to Use This List

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.