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 | |
|---|---|---|---|---|---|
| Y353 | EAPG- Multiple E/M codes same day without modifier -27. Evaluate adding to second and subsequent E/… |
N657
This should be billed with the appropriate code for th… |
CO | 16 | View → |
| Y354 | EAPG- Inherent bilateral procedure. Consider removing modifier -50 from this code. |
N644
Reimbursement has been made according to the bilateral… |
CO | 4 | View → |
| Y355 | EAPG- Duplicate lab or pathology code. Add modifier 59, 91, XE, XP, XS, or XU if documentation sup… |
M86
Service denied because payment already made for same/s… |
CO | 18 | View → |
| Y357 | EAPG- ADD ON CODE REPORTED WITHOUT BASED PROCEDURE. |
M20
Missing/incomplete/invalid HCPCS. |
CO | 16 | View → |
| Y358 | EAPG- Modifier -25 is reported for a Medical Visit EAPG with no Significant Procedure EAPG present… |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 16 | View → |
| Y359 | EAPG- DIAGNOSIS CODE IS REPORTED. ENSURE THAT MODIFIER PA, PB, OR PC IS ALSO REPORTED. |
M64
Missing/incomplete/invalid other diagnosis. |
CO | 16 | View → |
| Y36 | PROCEDURE CODE IS NON-COVERED. THE DESIGNATED DIAGNOSIS IS PRESENT. |
N569
Not covered when performed for the reported diagnosis. |
CO | 96 | View → |
| Y360 | EAPG- MODIFIER PA, PB, OR PC IS REPORTED. ENSURE THAT DIAGNOSIS CODE IS ALSO REPORTED. |
M64
Missing/incomplete/invalid other diagnosis. |
CO | 16 | View → |
| Y361 | EAPG- Duplicate diagnostic or therapeutic procedures. Add modifier if documentation supports use t… |
M86
Service denied because payment already made for same/s… |
CO | 96 | View → |
| Y362 | EAPG- MODIFIER REPORTED FOR THIS CODE IS SUPPRESSING NCCI EDIT. REVIEW DOCUMENTATION TO DETERMINE I… |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 97 | View → |
| Y363 | EAPG- Revenue code reported requires Reason for Visit diagnosis code. |
M64
Missing/incomplete/invalid other diagnosis. |
CO | 16 | View → |
| Y364 | EAPG- Modifier 59 is reported. Consider reporting modifier XE, XP, XS, or XU instead if more approp… |
N657
This should be billed with the appropriate code for th… |
CO | 4 | View → |
| Y365 | EAPG- Units of service for ancillary observation hours must be reported in the range of 8 to 24 hou… |
M53
Missing/incomplete/invalid days or units of service. |
CO | 16 | View → |
| Y367 | EAPG- This mutually exclusive code is paired with another code to trigger edit 3019. |
M80
Not covered when performed during the same session/dat… |
CO | 97 | View → |
| Y368 | EAPG- This mutually exclusive code is paired with another code to trigger edit 3020. |
M80
Not covered when performed during the same session/dat… |
CO | 97 | View → |
| Y369 | EAPG- This mutually exclusive code is paired with another code to trigger edit 3039. |
M80
Not covered when performed during the same session/dat… |
CO | 97 | View → |
| Y37 | PROCEDURE CODE IS NON-COVERED. THE NO EXEMPTION CODE IS PRESENT ON CLAIM |
N569
Not covered when performed for the reported diagnosis. |
CO | 96 | View → |
| Y370 | EAPG- This Column 1 code is paired with a Column 2 code to trigger edit 3040. |
M80
Not covered when performed during the same session/dat… |
CO | 97 | View → |
| Y371 | EAPG- Corneal transplant coded. Ensure that if appropriate, acquisition of the corneal tissue is al… |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y372 | EAPG- Transfusion is coded. Ensure that blood and blood products transfused are also coded. |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y373 | EAPG- Brachytherapy is coded. Ensure that brachytherapy seeds or radioelement is also coded. |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y374 | EAPG- Nuclear medicine is coded. Ensure that radiopharmaceuticals used in nuclear medicine procedur… |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y375 | EAPG- Infusion therapy is coded. Ensure that the substance infused is also coded. |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y376 | EAPG- Chemotherapy is coded. Ensure that chemotherapeutic agents and other supportive drugs are als… |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y377 | EAPG- Vaccination is coded. Ensure that the vaccine administered is also coded. |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y378 | EAPG- Injection is coded. Ensure that the substance injected is also coded. |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y379 | EAPG- Lens implant is coded. Ensure that the intraocular lens is also coded if applicable. |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y38 | PROCEDURE CODE IS NON-COVERED. |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 96 | View → |
| Y380 | EAPG- Neurostimulator implantation is coded. Ensure that the neurostimulator is also coded. |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y381 | EAPG- Insertion of prosthesis is coded. Ensure that the penile prosthesis is also coded. |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y382 | EAPG- Radiology procedure with contrast is coded. Ensure that the contrast material is also coded. |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y383 | EAPG- Interventional radiology procedure is coded. Ensure that the surgical intervention is also co… |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y384 | EAPG- A 3D rendering radiology procedure is coded. Ensure that the base radiology procedure is also… |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y385 | EAPG- Surgical placement of device for clinical brachytherapy has been coded. Ensure that applicat… |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y386 | EAPG- Skin substitute is coded. Ensure that application of the skin substitute is also coded. |
M84
Medical code sets used must be the codes in effect at … |
CO | 16 | View → |
| Y387 | EAPG - NCCI Medicaid FAC - Procedure code pair conflict is allowed if an appropriate NCCI modifier … |
N431
Not covered with this procedure. |
CO | 96 | View → |
| Y395 | Duplicate Claim. |
N522
Duplicate of a claim processed, or to be processed, as… |
CO | 18 | View → |
| Y397 | Procedure code was billed with more than one assistant surgeon. Only one surgical assistant is all… | — | CO | 54 | View → |
| Y4 | THE PATIENT AGE IS INVALID |
N329
Missing/incomplete/invalid patient birth date. |
CO | 16 | View → |
| Y402 | T1015 procedure code must be billed as the first procedure code on the claim. |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 96 | View → |
| Y403 | Claim does not contain the appropriate ER, observation or psychiatric clinic services for Illinois … |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 96 | View → |
| Y41 | ICD-10: PROCEDURE CODE IS LIMITED COVERAGE OR IS ASSOCIATED WITH A LIMITED COVERAGE DIAGNOSIS CODE … |
N657
This should be billed with the appropriate code for th… |
CO | 11 | View → |
| Y42 | THE PROCEDURE CODE SHOULD NOT BE REPORTED WHEN THE PATIENTâS LENGTH OF STAY IS LESS THAN FOUR DAY… |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 96 | View → |
| Y448 | (Physician/Ancillary)Per Medicaid's Medically Unlikely Edits Policy, total units billed for procedu… |
M53
Missing/incomplete/invalid days or units of service. |
CO | 222 | View → |
| Y449 | (Outpatient)Per Medicaid's Medically Unlikely Edits Policy, total units billed for procedure exceed… |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 222 | View → |
| Y450 | Physician/Ancillary)Per Medicaid's CCI Guidelines, Procedure Code has an unbundle relationship with… |
M15
Separately billed services/tests have been bundled as … |
CO | 234 | View → |
| Y451 | (Physician/Ancillary)Per Medicaid's CCI Guidelines, History Procedure Code on Claim has an unbundle… |
M15
Separately billed services/tests have been bundled as … |
CO | 234 | View → |
| Y452 | (Outpatient)Per Medicaid's CCI Guidelines, Procedure Code has an unbundle relationship with another… |
M15
Separately billed services/tests have been bundled as … |
CO | 234 | View → |
| Y453 | (Outpatient)Per Medicaid's CCI Guidelines, History Procedure Code has an unbundle relationship with… |
M15
Separately billed services/tests have been bundled as … |
CO | 234 | View → |
| Y455 | IL MCD emergency contraceptive pills must be billed using J8499 effective with dates of service Jun… |
M119
Missing/incomplete/invalid/ deactivated/withdrawn Nati… |
CO | 96 | 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.