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 | |
|---|---|---|---|---|---|
| 209 | PER REGULATORY OR OTHER AGREEMENT. THE PROVIDER CANNOT COLLECT THIS AMOUNT FROM THE PATIENT. HOWEVE… | — | CO | 45 | View → |
| 210 | PAYMENT ADJUSTED BECAUSE PRE-CERTIFICATION/AUTHORIZATION NOT RECEIVED IN A TIMELY FASHION |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 210 | View → |
| 211 | NATIONAL DRUG CODES (NDC) NOT ELIGIBLE FOR REBATE, ARE NOT COVERED. |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 211 | View → |
| 212 | ADMINISTRATIVE SURCHARGES ARE NOT COVERED |
N174
This is not a covered service/procedure/ equipment/bed… |
CO | 212 | View → |
| 213 | NON-COMPLIANCE WITH THE PHYSICIAN SELF REFERRAL PROHIBITION LEGISLATION OR PAYER POLICY. |
N475
Missing completed referral form. |
CO | 213 | View → |
| 216 | BASED ON THE FINDINGS OF A REVIEW ORGANIZATION | — | CO | 216 | View → |
| 224 | PATIENT IDENTIFICATION COMPROMISED BY IDENTITY THEFT. IDENTITY VERIFICATION REQUIRED FOR PROCESSING… |
N30
Patient ineligible for this service. |
OA | 224 | View → |
| 231 | MUTUALLY EXCLUSIVE PROCEDURES CANNOT BE DONE IN THE SAME DAY/SETTING. | — | CO | 231 | View → |
| 245 | PROVIDER NOT ELIGIBLE TO RECEIVE PAYMENT PER HFS OIG GUIDANCE. | — | CO | 245 | View → |
| 300L | DME SERVICE EXCEEDS QUANTITY LIMITS. SVC LIMITED TO 300 EVERY 30 DAYS. |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 222 | View → |
| 800U | SERVICES EXCEEDING 800 UNITS PER MEMBER/PER PROVIDER REQUIRE PRE-AUTHORIZATION. |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 197 | View → |
| 837 | CLAIM HAS BEEN REPROCESSED FOR SYSTEM RECONCILIATION, NOT IN RESPONSE TO INQUIRY OR RESUBMISSION BY… |
N377
Payment based on a processed replacement claim. |
CO | B13 | View → |
| 2014 | MUE-MEDICAID FAC- HCPCS UNITS FOR LINE ITEM EXCEED MEDICALLY UNLIKELY EDIT MAXIMUM OF XX. APPROPRI… |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 96 | View → |
| 2020 | FAC MUE-HPCPS LINE ITEM UNITS EXCEED MEDICALLY UNLIKELY EDIT MAXIMUM OF XX. |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 96 | View → |
| 2030 | FAC MUE-HCPCS TOTAL UNITS EXCEED DAILY ALLOWED MEDICALLY UNLIKELY EDIT MAXIUM OF XX CONTRARY TO CMS… |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 96 | View → |
| 2040 | FAC MUE- HCPCS TOTAL UNITS EXCEED DAILY ALLOWED MEDICALLY UNLIKELY EDIT MAXIMUM OF XX BASED ON CLIN… |
N362
The number of Days or Units of Service exceeds our acc… |
CO | 96 | View → |
| 2220 | MUE-MEDICAID FAC- PROCEDURE CODE PAIR CONFLICT WITH 'XXXXX' AND IS NOT ALLOWED EVEN IF APPROPRIATE … |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 16 | View → |
| 2240 | NCCI MEDICAID FAC- PROCEDURE CODE PAIR CONFLICT WITH 'XXXXX' AND IS ALLOWED IF AN APPROPRIATE NCCI … |
N519
Invalid combination of HCPCS modifiers. |
CO | 16 | View → |
| 3005 | EAPG-EXTERNAL CAUSE OF MORBIDITY CODE CANNOT BE USED AS PRIMARY OR PRINCIPAL DIAGNOSIS. |
MA63
Missing/incomplete/invalid principal diagnosis. |
CO | 16 | View → |
| 3006 | EAPG-INVALID PROCEDURE CODE. |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 16 | View → |
| 3018 | EAPG-SERVICE CONSIDERED AN INPATIENT PROCEDURE. |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 16 | View → |
| 3019 | NCCI MEDICARE FAC- MUTUALLY EXCLUSIVE PROCEDURE CODE PAIR CONFLICT WITH 'XXXXX' AND IS NOT ALLOWED … |
M86
Service denied because payment already made for same/s… |
CO | 97 | View → |
| 3020 | NCCI MEDICARE FAC-PROCEDURE CODE PAIR CONFLICT WITH 'XXXXX' AND IS NOT ALLOWED EVEN IF APPROPRIATE … |
M86
Service denied because payment already made for same/s… |
CO | 97 | View → |
| 3021 | EAPG-MEDICAL VISITS REPORTED WITHOUT MODIFIER -25 OR -27 ON THE SAME DAY AS A SIGNIFICANT PROCEDURE. |
N519
Invalid combination of HCPCS modifiers. |
CO | 16 | View → |
| 3022 | EAPG-MODIFIER 'XX' IS INVALID. |
N519
Invalid combination of HCPCS modifiers. |
CO | 16 | View → |
| 3024 | EAPG-DATE OF SERVICE IS OUT OF DATE RANGE FOR GROUPER. |
N647
Adjusted based on diagnosis-related group (DRG). |
CO | 96 | View → |
| 3025 | EAPG-INVALID AGE. |
N329
Missing/incomplete/invalid patient birth date. |
CO | 16 | View → |
| 3026 | EAPG-INVALID SEX. |
MA39
Missing/incomplete/invalid gender. |
CO | 16 | View → |
| 3039 | NCCI MEDICARE FAC- MUTUALLY EXCLUSIVE PROCEDURE CODE PAIR CONFLICT WITH 'XXXXX' AND IS ALLOWED IF A… |
M86
Service denied because payment already made for same/s… |
CO | 97 | View → |
| 3040 | NCCI MEDICARE FAC-PROCEDURE CODE PAIR CONFLICT WITH 'XXXXX' AND IS ALLOWED IF AN APPROPRIATE NCCI M… |
M86
Service denied because payment already made for same/s… |
CO | 97 | View → |
| 3041 | EAPG-REVENUE CODE 'XXXX' IS INVALID. |
M50
Missing/incomplete/invalid revenue code(s). |
CO | 16 | View → |
| 3048 | EAPG-REVENUE CODE 'XXXX' REQUIRES HCPCS CODE ON SAME LINE. |
M20
Missing/incomplete/invalid HCPCS. |
CO | 16 | View → |
| 3074 | EAPG-UNITS OF SERVICE GREATER THAN ONE IS INAPPROPRIATE FOR BILATERAL PROCEDURE REPORTED WITH MODIF… |
M53
Missing/incomplete/invalid days or units of service. |
CO | 16 | View → |
| 3101 | EAPG-INVALID DIAGNOSIS CODE, 4TH OR 5TH DIGIT REQUIRED. |
M64
Missing/incomplete/invalid other diagnosis. |
CO | 16 | View → |
| 3102 | EAPG-INVALID DIAGNOSIS CODE. |
M64
Missing/incomplete/invalid other diagnosis. |
CO | 16 | View → |
| 3103 | EAPG-AGE CONFLICT-DIAGNOSIS CONSIDERED ONLY FOR NEWBORNS, AGE <1 YEAR. | — | CO | 9 | View → |
| 3104 | EAPG- AGE CONFLICT -DIAGNOSIS CONSIDERED ONLY FOR PEDIATRIC PATIENTS, AGE <18 YEARS. | — | CO | 9 | View → |
| 3105 | EAPG- AGE CONFLICT-DIAGNOSIS CONSIDERED ONLY FOR MATERNITY, FEMALES 12-55 YEARS. | — | CO | 9 | View → |
| 3106 | EAPG- AGE CONFLICT -DIAGNOSIS CONSIDERED ONLY FOR ADULTS, AGE 15 AND UP. | — | CO | 9 | View → |
| 3107 | EAPG- SEX CONFLICT-DIAGNOSIS CODE IS ONLY VALID FOR MALE PATIENTS. MAY REQUIRE CONDITION CODE 45 T… | — | CO | 10 | View → |
| 3108 | EAPG- SEX CONFLICT-DIAGNOSIS CODE IS ONLY VALID FOR FEMALE PATIENTS. MAY REQUIRE CONDITION CODE 45… | — | CO | 10 | View → |
| 3111 | EAPG- SEX CONFLICT-PROCEDURE ONLY VALID FOR MALE PATIENTS. MAY REQUIRE CONDITION CODE 45 AND MODIF… | — | CO | 7 | View → |
| 3112 | EAPG- SEX CONFLICT-PROCEDURE ONLY VALID FOR FEMALE PATIENTS. MAY REQUIRE CONDITION CODE 45 AND MOD… | — | CO | 7 | View → |
| 3115 | EAPG-FROM DATE IS INVALID OR BLANK. THIS IS A REQUIRED FIELD. |
M52
Missing/incomplete/invalid 'from' date(s) of service. |
CO | 16 | View → |
| 3116 | EAPG-THROUGH DATE IS INVALID OR BLANK. THIS IS A REQUIRED FIELD. |
M59
Missing/incomplete/invalid 'to' date(s) of service. |
CO | 16 | View → |
| 3117 | EAPG-LINE ITEM SERVICE DATE IS INVALID OR BLANK. THIS IS A REQUIRED FIELD. |
MA31
Missing/incomplete/invalid beginning and ending dates … |
CO | 16 | View → |
| 3118 | EAPG-LINE ITEM SERVICE DATE IS NOT WITHIN THE FROM-THROUGH DATES. |
MA31
Missing/incomplete/invalid beginning and ending dates … |
CO | 16 | View → |
| 3119 | EAPG-FROM DATE CANNOT BE AFTER THROUGH DATE. |
M52
Missing/incomplete/invalid 'from' date(s) of service. |
CO | 16 | View → |
| 3120 | EAPG-TERMINATED BILATERAL PROCEDURE. DO NOT USE MODIFIER -50 WHEN REPORTING A TERMINATED PROCEDURE. |
N519
Invalid combination of HCPCS modifiers. |
CO | 16 | View → |
| 3121 | EAPG-TERMINATED PROCEDURE WITH UNITS GREATER THAN ONE. DO NOT USE MULTIPLE UNITS WHEN REPORTING A T… |
M53
Missing/incomplete/invalid days or units of service. |
CO | 16 | 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.