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 | |
|---|---|---|---|---|---|
| ZMD | MAXIMUM DEDUCTIBLE FOR THIS TIME PERIOD HAS BEEN REACHED. | — | OA | 1 | View → |
| ZMDC | MEDICARE'S APPROVED AMOUNT IS LESS THAN $0. PLEASE RESUBMIT A CORRECTED MEDICARE STATEMENT |
N479
Missing Explanation of Benefits (Coordination of Benef… |
CO | 16 | View → |
| ZMDE | THE MAXIMUM DAYS SUPPLY FOR THIS ITEM HAS BEEN USED |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 119 | View → |
| ZMDI | MODIFIER SUBMITTED IS INVALID. |
N572
This procedure is not payable unless appropriate non-p… |
CO | 182 | View → |
| ZMDO | THE MAXIMUM DAYS FOR THIS ITEM/SERVICE HAS BEEN USED |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 119 | View → |
| ZMDS | THE MINIMUM DAYS SUPPLY REQUIRED HAS NOT BEEN MET |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 96 | View → |
| ZMFO | THE MAXIMUM FILLS FOR THIS ITEM HAVE BEEN USED |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 119 | View → |
| ZMNA | MEMBER WAS NOT ACTIVE FOR THE FULL TIME PERIOD OF THIS CLAIM |
N30
Patient ineligible for this service. |
OA | 200 | View → |
| ZMQE | THE MAXIMUM QUANTITY ALLOWED HAS BEEN USED |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 119 | View → |
| ZMQO | THE MAXIMUM QUANTITY FOR THIS ITEM/SERVICE HAS BEEN USED |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 119 | View → |
| ZMQR | THE MINIMUM QUANITY REQUIRED HAS NOT BEEN MET |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 96 | 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 → |
| ZPCP | PCP REJECT PC01 TESTING | — | CO | 16 | View → |
| ZPGP | THIS MEMBER'S ELIGIBILITY IS PAST THE GRACE PERIOD PAID THROUGH DATE |
N30
Patient ineligible for this service. |
OA | 32 | View → |
| ZPPH | PREAUTHORIZATION IS REQUIRED FOR THIS SERVICE |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 197 | View → |
| ZPX | THESE ARE NON-COVERED SERVICES BECAUSE THIS IS A PRE-EXISTING CONDITION |
N30
Patient ineligible for this service. |
CO | 51 | View → |
| ZQDN | QUADRANT DOES NOT MATCH SPECIFIED TOOTH. |
N37
Missing/incomplete/invalid tooth number/letter. |
CO | 16 | View → |
| ZQUA | QUADRANT REQUIRED FOR PROCEDURE. |
N37
Missing/incomplete/invalid tooth number/letter. |
CO | 16 | View → |
| ZSN | MINIMUM OR MAXIMUM NUMBER OF SURFACES REQUIRED |
N75
Missing/incomplete/invalid tooth surface information. |
CO | 16 | View → |
| ZSPA | SPOUSE OVER AGE LIMIT. |
N30
Patient ineligible for this service. |
CO | 177 | View → |
| ZTNR | TOOTH NUMBER IS REQUIRED FOR THIS PROCEDURE |
N37
Missing/incomplete/invalid tooth number/letter. |
CO | 16 | View → |
| 1 | DEDUCTIBLE AMOUNTS | — | OA | 1 | View → |
| 1D | RECALC/CORRECTED BILLING SUBMITTED |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 96 | View → |
| 1NPL | SERVICES ARE LIMITED TO ONE NEW PATIENT VISIT PER LIFETIME. |
MA130
Your claim contains incomplete and/or invalid informat… |
CO | 16 | 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 → |
| 1P2Y | SERVICES ARE LIMITED TO ONE EVERY 2 YEARS |
N640
Exceeds number/frequency approved/allowed within time … |
CO | 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 → |
| 1PP | SERVICE IS LIMITED TO ONCE PER PREGNANCY. |
N640
Exceeds number/frequency approved/allowed within time … |
CO | 222 | View → |
| 1PYR | SERVICES LIMITED TO ONCE PER YEAR. |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 222 | View → |
| 02EA | EAPG CLAIM NOT PROCESSED; INVALID CLAIM FROM OR THROUGH DATE, OR OUTSIDE SUPPORTED PERIOD. |
MA31
Missing/incomplete/invalid beginning and ending dates … |
CO | 16 | View → |
| 2 | COINSURANCE AMOUNT | — | OA | 2 | View → |
| 2HLM | PRIOR AUTH IS REQUIRED AFTER UNITS EXCEED 200 UNITS PER MEMBER PER PROVIDER |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 197 | View → |
| 03EA | EAPG CLAIM NOT PROCESSED; SINGLE VISIT OPTION NOT SELECTED IN SCHEDULE AND LINE DATE NOT WITHIN FRO… |
N182
This claim/service must be billed according to the sch… |
CO | 16 | View → |
| 3 | CO-PAYMENT AMOUNT | — | OA | 3 | View → |
| 3DI | MUST BILL BASE RADIOLOGY PROCEDURE WITH 3D IMAGING |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 16 | View → |
| 3P12 | SERVICE IS LIMITED TO 3 TIMES WITHIN A 12 MONTH PERIOD. |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 222 | View → |
| 3P6 | SERVICE IS LIMITED TO 3 TIMES WITHIN A 6 MONTH PERIOD. |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 222 | View → |
| 04EA | EAPG CLAIM NOT PROCESSED; CLAIM HAS NO VALID VISITS. |
M53
Missing/incomplete/invalid days or units of service. |
CO | 16 | View → |
| 4PYR | SERVICES ARE LIMITED TO 4 PER YEAR |
N362
The number of Days or Units of Service exceeds our acc… |
OA | 222 | View → |
| 4U | SERVICES EXCEEDING 4 UNITS PER DAY REQUIRE PRE-AUTHORIZATION. |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 197 | View → |
| 4UDM | PRIOR AUTHORIZATION REQUIRED FOR SERVICES EXCEEDING 4 UNITS PER DAY. |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 197 | View → |
| 05EA | EAPG CLAIM NOT PROCESSED; NO PRIMARY DIAGOSNIS CODE. |
M76
Missing/incomplete/invalid diagnosis or condition. |
CO | 16 | View → |
| 5 | THE PROCEDURE CODE/BILL TYPE IS INCONSISTENT WITH THE PLACE OF SERVICE. |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 5 | View → |
| 6 | THE PROCEDURE/REVENUE CODE IS INCONSISTANT WITH THE PATIENT'S AGE. |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 6 | View → |
| 7 | THE PROCEDURE/REVENUE CODE IS INCONSISTENT WITH THE PATIENT'S GENDER. |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 7 | View → |
| 8 | THE PROCEDURE CODES IS INCONSISTENT WITH THE PROVIDER TYPE/SPECIALTY (TAXONOMY). |
N255
Missing/incomplete/invalid billing provider taxonomy. |
CO | 8 | View → |
| 9 | THE DIAGNOSIS IS INCONSISTENT WITH THE PATIENT'S AGE. |
M64
Missing/incomplete/invalid other diagnosis. |
CO | 9 | View → |
| 10 | THE DIAGNOSIS IS INCONSISTENT WITH THE PATIENT'S GENDER. |
M64
Missing/incomplete/invalid other diagnosis. |
CO | 10 | View → |
| 10CC | CRITICAL CARE IS LIMITED TO 10 VISITS PER CONFINEMENT. |
N640
Exceeds number/frequency approved/allowed within time … |
CO | 222 | 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.