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 | |
|---|---|---|---|---|---|
| PGIF | Payment Integrity Clinical Audit recovery/recoupment that was internally identified by the Evolent … |
N35
Program integrity/utilization review decision. |
OA | 16 | View → |
| PHV | CLAIM HAS BEEN MISDIRECTED FOR NON-PHARMACY SERVICES. | — | CO | 109 | View → |
| PI | PAYMENT FOR SERVICES INCLUDED AS PART OF PER DIEM/DRG |
M15
Separately billed services/tests have been bundled as … |
CO | 97 | View → |
| PID | PRIMARY INSURANCE'S EOB IS LACKING DENIAL REASON FOR NON-PAYMENT OF CLAIM. |
MA04
Secondary payment cannot be considered without the ide… |
CO | 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 → |
| PNV | PRENATAL VISIT IS ONLY PAYABLE WITH CODE 0502F. |
M20
Missing/incomplete/invalid HCPCS. |
CO | 181 | View → |
| PO | VERIFY PLACE OF SERVICE AND/OR CPT CODES. INCONSISTANT WITH RELATED CHARGES AND/OR AUTHORIZATION. | — | CO | 58 | View → |
| POAI | THE POA INDICATOR SUBMITTED IS INVALID. PLEASE REVIEW ALL ICD10 CODE FOR POA APPLICABILITY. THIS … |
N434
Missing/Incomplete/Invalid Present on Admission indica… |
CO | 16 | View → |
| POAM | POA INDICATORS ARE REQUIRED. PLEASE REVIEW ALL ICD10 CODES FOR POA APPLICABILITY. THIS CLAIM CANN… |
N434
Missing/Incomplete/Invalid Present on Admission indica… |
CO | 16 | View → |
| POD | PODIATRIC SERVICES REQUIRE PA AFTER 6 VISITS |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 197 | View → |
| PODI | INITIAL VISIT ONLY COVERED ONCE PER PATIENT PER PROVIDER OR PROVIDER GROUP |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 222 | View → |
| PODN | REIMBURSEMENT NOT SUPPORTED BY CONTRACT | — | CO | 204 | View → |
| PP1 | THIS SERVICE IS LIMITED TO ONE POSTPARTUM VISIT PER PREGNANCY. |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 222 | View → |
| PPC | PROVIDER PREVENTABLE CONDITIONS ARE INELIGIBLE FOR BENEFIT |
M64
Missing/incomplete/invalid other diagnosis. |
CO | 167 | View → |
| PPIR | Potentially Preventable Inpatient Readmission within 30 days | — | CO | 249 | View → |
| PPOI | OON PROVIDER PROCESSED IN NET BENEFITS |
N381
Alert: Consult our contractual agreement for restricti… |
CO | 45 | View → |
| PPT | THIS PROCEDURE IS ONLY PAYABLE ONCE PER PREGNANCY. |
N640
Exceeds number/frequency approved/allowed within time … |
CO | 119 | View → |
| PPVF | TWO PNEUMOCOCCAL PNEUMONIA VACCINES BILLED IN ONE YEAR - CLAIM MUST HAVE CORRECT DX CODES BILLED TO… |
N640
Exceeds number/frequency approved/allowed within time … |
CO | 151 | View → |
| PRAU | PRE-AUTHORIZATION REQUIRED FOR PROSTHETICS $500.00 BILLED CHARGES OR MORE |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 197 | View → |
| PRER | REIMBURSEMENT HAS BEEN REDUCED DUE TO PREADMISSION/PREOPERATIVE TESTING PAID WITHIN 72 HOURS. | — | CO | 203 | View → |
| PROS | PENILE PROSTHESIS MUST BE BILLED WITH PROCEDURE CODES FOR INSERTION |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 16 | View → |
| PSB | PER HFS PSYCH TYPE B INTENSIVE OUTPATIENT PROGRAM MUST BE BILLED WITH REV CODE 0913, AND PARTIAL HO… |
M50
Missing/incomplete/invalid revenue code(s). |
CO | 16 | View → |
| PSYC | CODE CANNOT BE BILLED AS A STAND ALONE CODE |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 16 | View → |
| PSYH | CLAIM HAS BEEN MISDIRECTED. THIS IS NOT A COVERED SERVICE UNDER THE PLAN. PLEASE SUBMIT CLAIM TO B… | — | CO | 109 | View → |
| PTS2 | THERAPY EXCEEDING 12 VISITS/HOURS PER 30 DAYS REQUIRES PRE-AUTHORIZATION. |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 197 | View → |
| PVT | PRIVATE ROOM CHARGES ARE NOT COVERED | — | CO | 78 | View → |
| PWR | THE SUBMITTED EOP FROM THE PRIMARY INSURANCE DOES NOT MATCH THE SERVICE/DATE(S) RENDERED. | — | CO | 22 | View → |
| R942 | REVENUE CODE 0942 CAN ONLY BE BILLED BY LTC PROVIDERS PER HFS GUIDELINES. PLEASE RESUBMIT YOUR CLAI… |
M50
Missing/incomplete/invalid revenue code(s). |
CO | 272 | View → |
| RAD | RADIOLOGY WITH CONTRAST PROCEDURE MUST BE BILLED WITH CONTRAST MATERIAL |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 16 | View → |
| RAR | CLAIM REPROCESSED DUE TO RETRO ELIGIBILITY RECEIVED. |
MA67
Alert: Correction to a prior claim. |
CO | 169 | View → |
| RCOP | CLAIM HAS BEEN REPROCESSED DUE TO DEDUCTIBLE AND/OR OUT OF POCKET MET. REFUND MAY BE OWED TO PATIE… | — | OA | 2 | View → |
| RCPT | REVENUE CODE BILLED REQUIRES DETAILED CODING WITH HCPCS/CPT4 IN ORDER FOR CLAIM TO BE CONSIDERED FO… |
M20
Missing/incomplete/invalid HCPCS. |
CO | 16 | View → |
| RCPX | PROVIDER IS NOT ELIGIBLE FOR THIS MEMBER UNDER THE RIGHT CHOICE PROGRAM. |
N95
This provider type/provider specialty may not bill thi… |
CO | 184 | View → |
| RDP | RECEIVED DATE IS PRIOR TO DATE OF SERVICE. | — | CO | 110 | View → |
| REV | REVENUE CODE BILLED IS INVALID. PLEASE BILL WITH A VALID REVENUE CODE FOR CONSIDERATION. |
M50
Missing/incomplete/invalid revenue code(s). |
CO | 16 | View → |
| RFCL | ROUTINE FOOT CARE IS LIMITED TO ONCE VERY 60 DAYS. |
N640
Exceeds number/frequency approved/allowed within time … |
CO | 119 | View → |
| RKX | THE PLAN DOES NOT PROVIDE BENEFITS FOR REFRACTIVE EYE SURGERY. | — | CO | 204 | View → |
| RMID | MISSING OR INVALID MEDICAID ID FOR REFERRING PROVIDER BILLED | — | CO | 256 | 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 → |
| RNDC | NDC NUMBER IS REQUIRED. THIS CLAIM CANNOT BE PROCESSED UNTIL A CORRECT CLAIM HAS BEEN RECEIVED. |
M119
Missing/incomplete/invalid/ deactivated/withdrawn Nati… |
CO | 16 | View → |
| RORP | ALERT (ORP): Entity's National Provider Identifier (NPI). Missing or invalid information. | — | OA | 206 | View → |
| RPNC | REPAIR COSTS COVERED BY WARRANTY ARE NOT COVERED. |
N171
Payment for repair or replacement is not covered or ha… |
CO | 96 | View → |
| RPNF | Referring Provider Not Found |
N286
Missing/incomplete/invalid referring provider primary … |
CO | 206 | View → |
| RPPD | REF PROV NOT FOUND-PLAN DIRECTED CARE |
N286
Missing/incomplete/invalid referring provider primary … |
CO | 206 | View → |
| RQ50 | SUBMITTED COST IS REQUIRED. |
M25
The information furnished does not substantiate the ne… |
CO | 16 | View → |
| RQME | SUBMITTED MODIFIER NOT ACTIVE. | — | CO | 182 | View → |
| RRC | PURCHASE OF SUPPLY NOT ELIGIBLE. THIS SUPPLY CAN ONLY BE RENTED. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 96 | View → |
| RT | NON-TIMELY FILED CLAIM, PATIENT NOT RESPONSIBLE. | — | CO | 29 | View → |
| RTFT | ROUTINE FOOT CARE IS NOT COVERED UNDER THE PLAN. | — | CO | 204 | 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.