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 | |
|---|---|---|---|---|---|
| XN35 | CLAIM PAID AT ENCOUNTER RATE | — | CO | 45 | View → |
| XN36 | LONG ACTING CONTRACEPTIVE DEVICES (LARCS) ARE FEE-FOR-SERVICE WHEN BILLED SEPARATELY |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 96 | View → |
| XN39 | DME PROCEDURES BILLED WITH RR MODIFIER AND NO RENTAL PRICE IS NOTED, REIMBURSEMENT IS 10% OF PURCHA… | — | CO | 45 | View → |
| XN40 | IF A SUPR/DASA PROVIDER IS BILLING WITH TAXONOMY 324500000X OR 3245S0500X, AN ADMISSION CODE FROM 1… |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 16 | View → |
| XN46 | HOSPICE REV 0657 MUST HAVE A CORRESPONDING CPT/HCPC CODE BILLED |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 16 | View → |
| XN48 | DENTAL FLOURIDE (D1206/D1208) IS ONLY APPLICABLE TWICE A YEAR FOR AGES 3-20 |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 16 | View → |
| XN53 | Procedure code {CPT} is not valid for member age |
N129
Not eligible due to the patient's age. |
CO | 16 | View → |
| XN54 | CRNA and Anesthesiologist can no longer bill surgery procedures effective 10/01/2021. |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 16 | View → |
| XN55 | CPT CODE IS NOT ALLOWED WITH BILLED OUTPATIENT PSYCH REVENUE CODE |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 16 | View → |
| Y1 | ADMISSION DIAGNOSIS: THE ADMISSION DIAGNOSIS IS INVALID OR DISABLED. |
MA65
Missing/incomplete/invalid admitting diagnosis. |
CO | 16 | View → |
| Y10 | ADMISSION DIAGNOSIS IS NOT TYPICAL FOR A PATIENT OF THIS AGE. |
N657
This should be billed with the appropriate code for th… |
CO | 9 | View → |
| Y11 | PRINCIPAL DIAGNOSIS IS NOT TYPICAL FOR A PATIENT OF THIS AGE. |
N657
This should be billed with the appropriate code for th… |
CO | 9 | View → |
| Y12 | OTHER DIAGNOSIS IS NOT TYPICAL FOR A PATIENT OF THIS AGE. |
N657
This should be billed with the appropriate code for th… |
CO | 9 | View → |
| Y13 | ADMISSION DIAGNOSIS IS NOT TYPICAL FOR A PATIENT OF THIS GENDER. |
N657
This should be billed with the appropriate code for th… |
CO | 10 | View → |
| Y14 | PRINCIPAL DIAGNOSIS IS NOT TYPICAL FOR A PATIENT OF THIS GENDER. |
N657
This should be billed with the appropriate code for th… |
CO | 10 | View → |
| Y145 | The taxonomy of the provider does not match the bill type. |
N255
Missing/incomplete/invalid billing provider taxonomy. |
CO | 16 | View → |
| Y147 | THE PROCEDURE WAS BILLED BY A PROVIDER NOT LISTED AS AN ANESTHESIOLOGY PROVIDER. |
N95
This provider type/provider specialty may not bill thi… |
CO | 96 | View → |
| Y15 | OTHER DIAGNOSIS IS NOT TYPICAL FOR A PATIENT OF THIS GENDER. |
N657
This should be billed with the appropriate code for th… |
CO | 10 | View → |
| Y16 | A MANIFESTATION CODE CAN NOT BE USED AS THE ADMITTING DIAGNOSIS. |
MA65
Missing/incomplete/invalid admitting diagnosis. |
CO | 16 | View → |
| Y160 | ADULT/MATERNITY/NEWBORN/PEDIATRIC DIAGNOSIS IS NOT TYPICAL FOR THE PATIENT'S AGE. |
N657
This should be billed with the appropriate code for th… |
CO | 9 | View → |
| Y161 | THE DIAGNOSIS IS INVALID OR DISABLED. |
M76
Missing/incomplete/invalid diagnosis or condition. |
CO | 16 | View → |
| Y162 | THERE IS NO PRIMARY DIAGNOSIS LISTED FOR THIS PROCEDURE. |
MA63
Missing/incomplete/invalid principal diagnosis. |
CO | 16 | View → |
| Y163 | THE DIAGNOSIS IS A NONSPECIFIC DIAGNOSIS CODE AND REQUIRES A FOURTH AND/OR FIFTH DIGIT. |
M76
Missing/incomplete/invalid diagnosis or condition. |
CO | 16 | View → |
| Y164 | THE DIAGNOSIS IS NOT TYPICAL FOR THE PATIENT'S GENDER. |
N657
This should be billed with the appropriate code for th… |
CO | 10 | View → |
| Y165 | THE DIAGNOSIS DESCRIBES AN EXTERNAL CAUSE, OR REQUIRES THE ICD CODE FOR THE FIRST UNDERLYING DISEAS… |
MA63
Missing/incomplete/invalid principal diagnosis. |
CO | 16 | View → |
| Y17 | A MANIFESTATION CODE CAN NOT BE USED AS THE PRINCIPAL DIAGNOSIS. |
MA63
Missing/incomplete/invalid principal diagnosis. |
CO | 16 | View → |
| Y174 | SAME CLAIM - THE E/M CODE WAS BILLED ON THE SAME DATE OF SERVICE OR ONE DAY PRIOR TO A DIFFERENT PR… |
N657
This should be billed with the appropriate code for th… |
CO | 4 | View → |
| Y18 | THE PRINCIPAL DIAGNOSIS IS NOT NORMALLY SUFFICIENT JUSTIFICATION FOR ADMISSION TO A HOSPITAL. |
N569
Not covered when performed for the reported diagnosis. |
CO | 96 | View → |
| Y19 | THE DIAGNOSIS CODE IS NOT ACCEPTABLE AS A PRINCIPAL DIAGNOSIS. |
MA63
Missing/incomplete/invalid principal diagnosis. |
CO | 16 | View → |
| Y193 | THE MODIFIER IS DISABLED/NOT VALID |
N519
Invalid combination of HCPCS modifiers. |
CO | 4 | View → |
| Y2 | PRINCIPAL DIAGNOSIS: THE PRINCIPAL DIAGNOSIS IS INVALID OR DISABLED. |
MA63
Missing/incomplete/invalid principal diagnosis. |
CO | 16 | View → |
| Y20 | THE DIAGNOSIS CODE IS NOT ACCEPTABLE AS A PRINCIPAL DIAGNOSIS UNLESS A SECONDARY DIAGNOSIS IS PRESE… |
M64
Missing/incomplete/invalid other diagnosis. |
CO | 16 | View → |
| Y208 | PER MEDICARE GUIDELINES, THE HCPCS CODE IS IDENTIFIED AS AN AMBULANCE CODE AND REQUIRES AN AMBULANC… |
N657
This should be billed with the appropriate code for th… |
CO | 4 | View → |
| Y209 | THE DIAGNOSTIC PROCEDURE CODE BILLED BY A PHYSICIAN REQUIRES A 26 MODIFIER WHEN PERFORMED IN A FACI… |
N657
This should be billed with the appropriate code for th… |
CO | 4 | View → |
| Y21 | HAC STATUS: ONE OR MORE HAC CRITERIA MET, FINAL DRG CHANGES |
N647
Adjusted based on diagnosis-related group (DRG). |
CO | 96 | View → |
| Y210 | THE PAYMENT MODIFIER IS REQUIRED TO BE IN THE FIRST POSITION WHEN BILLED UNLESS ANOTHER PAYMENT MOD… |
M81
You are required to code to the highest level of speci… |
CO | 16 | View → |
| Y22 | THE PRINCIPAL DIAGNOSIS CODE INDICATES THAT A WRONG PATIENT PROCEDURE WAS PERFORMED |
MA63
Missing/incomplete/invalid principal diagnosis. |
CO | 11 | View → |
| Y23 | THE OTHER DIAGNOSIS CODE INDICATES THAT A WRONG PATIENT PROCEDURE WAS PERFORMED |
N657
This should be billed with the appropriate code for th… |
CO | 11 | View → |
| Y24 | THE ADMISSION DIAGNOSIS IS A NONSPECIFIC DIAGNOSIS CODE AND REQUIRES A FOURTH AND/OR FIFTH DIGIT. |
MA65
Missing/incomplete/invalid admitting diagnosis. |
CO | 16 | View → |
| Y25 | THE PRINCIPAL DIAGNOSIS IS A NONSPECIFIC DIAGNOSIS CODE AND REQUIRES A FOURTH AND/OR FIFTH DIGIT. |
MA63
Missing/incomplete/invalid principal diagnosis. |
CO | 16 | View → |
| Y26 | THE OTHER DIAGNOSIS IS A NONSPECIFIC DIAGNOSIS CODE AND REQUIRES A FOURTH AND/OR FIFTH DIGIT. |
M64
Missing/incomplete/invalid other diagnosis. |
CO | 16 | View → |
| Y27 | THERE IS NO ADMISSION DIAGNOSIS LISTED FOR THIS PROCEDURE. |
MA65
Missing/incomplete/invalid admitting diagnosis. |
CO | 16 | View → |
| Y28 | THERE IS NO PRINCIPAL DIAGNOSIS LISTED FOR THIS PROCEDURE. |
MA63
Missing/incomplete/invalid principal diagnosis. |
CO | 16 | View → |
| Y29 | THE PRINCIPAL DIAGNOSIS CODE IS NON-EXEMPT AND REQUIRES A VALID POA INDICATOR. |
N434
Missing/Incomplete/Invalid Present on Admission indica… |
CO | 16 | View → |
| Y296 | Co-Surgeon modifier 62 indicates a 50% reduction of the state maximum shoud be applied. | — | CO | 45 | View → |
| Y297 | Co-Surgeon modifier 62 not applicable for procedure code. Line item not reimbursed. |
N657
This should be billed with the appropriate code for th… |
CO | 4 | View → |
| Y299 | Assistant Surgeon modifier not applicable for procedure code. Line item not reimbursed. |
N657
This should be billed with the appropriate code for th… |
CO | 4 | View → |
| Y3 | OTHER DIAGNOSIS: THE OTHER DIAGNOSIS IS INVALID OR DISABLED. |
M64
Missing/incomplete/invalid other diagnosis. |
CO | 16 | View → |
| Y30 | THE OTHER DIAGNOSIS CODE IS NON-EXEMPT AND REQUIRES A VALID POA INDICATOR. |
N434
Missing/Incomplete/Invalid Present on Admission indica… |
CO | 16 | View → |
| Y300 | Lab Panel reduction applied to line item. | — | CO | 45 | 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.