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 | |
|---|---|---|---|---|---|
| EST1 | ELECTIVE STERILIZATION FOR MEMBERS AGE 21 AND OLDER REQUIRES A CONSENT FORM. SERVICES DO NOT REQUI… |
N398
Missing elective consent form. |
CO | 163 | View → |
| EV17 | DEPENDENT OVER AGE LIMIT. |
N129
Not eligible due to the patient's age. |
OA | 6 | View → |
| FHFS | FAILURE TO ADHERE TO HFS GUIDELINES. | N514 | CO | 272 | View → |
| FHN | CLAIM HAS BEEN PAID IN ACCORDANCE WITH FIRST HEALTH NETWORK CONTRACT | — | CO | 59 | View → |
| FHUB | FAILURE TO ADHERE TO HFS GUIDELINES-D01/UB DUPLICATE. | N514 | CO | 272 | View → |
| FLVA | SERVICES ARE LIMITED TO FOUR PER YEAR. |
N640
Exceeds number/frequency approved/allowed within time … |
CO | 222 | View → |
| FQBG | MUST INCLUDE DETAIL LINES PER HFS BILLING GUIDELINES. |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 272 | View → |
| FQHC | PAID AT FQHC RATE |
N381
Alert: Consult our contractual agreement for restricti… |
CO | 144 | View → |
| FQPO | FQHC SERVICES MUST BE BILLED WITH THE APPROPRIATE PLACE OF SERVICE CODE. |
M77
Missing/incomplete/invalid/inappropriate place of serv… |
CO | 5 | View → |
| FQUB | T1015/S5190 IS ONLY ABLE TO BE SUBMITTED ON HCFA-1500 FORMS PER HFS. |
N34
Incorrect claim form/format for this service. |
CO | 16 | View → |
| FRD | PROVIDER UNDER INVESTIGATION. FOR MORE INFORMATION CALL PROVIDER RELATIONS. | — | CO | 206 | View → |
| FUD | E&M CODE INCLUDED IN GLOBAL RATE. PATIENT IS NOT RESPONSIBLE FOR BALANCE. |
N525
These services are not covered when performed within t… |
CO | 97 | View → |
| FV | OFFICE VISIT WITHIN GLOBAL SURGICAL PERIOD, NO ADDITIONAL PAYMENT DUE. |
N525
These services are not covered when performed within t… |
CO | 96 | View → |
| GAP | THE SERVICE DATE(S) BILLED FALL DURING A TIME WHEN THE MEMBER HAD A GAP IN COVERAGE. |
N650
This policy was not in effect for this date of loss. N… |
CO | 200 | View → |
| GEMT | Ground emergency transportation claims need to be submitted to HFS directly. |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 96 | View → |
| GFR | PRE-OPERATIVE OR PRE-ADMISSION TESTING IS INCLUDED WITH THE GLOBAL FACILITY REIMBURSEMENT. |
M15
Separately billed services/tests have been bundled as … |
CO | 97 | View → |
| GIS | THE SERVICES ARE INCLUDED IN THE GLOBAL IMAGING SERVICE AND ARE NOT SEPARATELY REIMBURSABLE. |
M15
Separately billed services/tests have been bundled as … |
CO | 97 | View → |
| GO | GLOBAL TO OTHER PROCEDURE(S) BILLED FOR THE SAME DATE OF SERVICE, PATIENT IS NOT RESPONSIBLE. |
N525
These services are not covered when performed within t… |
CO | 96 | View → |
| H47 | PROCEDURE CODE COMBINATION NOT ALLOWED. |
N20
Service not payable with other service rendered on the… |
CO | 97 | View → |
| HAR1 | ONE PAIR OF EYEGLASSES A YEAR |
N640
Exceeds number/frequency approved/allowed within time … |
OA | 119 | View → |
| HAR5 | ONE PAIR OF EYEGLASSES EVERY 5 YEARS |
N640
Exceeds number/frequency approved/allowed within time … |
OA | 119 | View → |
| HAX | MEMBER EXCEEDS AGE LIMIT FOR HEARING BENEFIT |
N129
Not eligible due to the patient's age. |
CO | 6 | View → |
| HCFA | FACILITY NOT ALLOWED TO BILL ON A HCFA. |
N34
Incorrect claim form/format for this service. |
CO | 16 | View → |
| HCRA | THIS ADDITIONAL PAYMENT REFLECTS 37.9% NY SURCHARGE ON PATIENT LIABILITY. | — | CO | 225 | View → |
| HCUB | SERVICES BILLED WITH APL CODE. SERVICES MUST BE BILLED ON UB CLAIM FORM. |
N34
Incorrect claim form/format for this service. |
CO | 16 | View → |
| HEAR | MAXIMUM FREQUENCY EXCEEDED. HEARING AIDS/COCHLEAR IMPLANTS ONE EVERY 12 MONTHS. |
N640
Exceeds number/frequency approved/allowed within time … |
CO | 119 | View → |
| HH32 | HOME HEALTH SERVICES REQUIRE AUTHORIZATION AFTER 32 UNITS OF SERVICE. |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 197 | View → |
| HH90 | HOME HEALTH SERVICES ARE LIMITED TO 90 VISITS WITHIN A TWELVE MONTH PERIOD |
N640
Exceeds number/frequency approved/allowed within time … |
CO | 222 | View → |
| HHDM | HOME HEALTH SERVICES REQUIRE PRIOR AUTH AFTER 32 UNITS HAVE BEEN EXCEEDED. |
M62
Missing/incomplete/invalid treatment authorization cod… |
CO | 197 | View → |
| HHFA | SERVICES SHOULD BE BILLED ON HCFA. |
N34
Incorrect claim form/format for this service. |
CO | 16 | View → |
| HHS | HOME HEALTH SERVICES LIMITED TO 100 VISITS PER YEAR. |
N640
Exceeds number/frequency approved/allowed within time … |
OA | 119 | View → |
| HHV | HOME HEALTH VISITS: 1 visit per day, if the CPT code is not listed in the contract it is not paid. |
N640
Exceeds number/frequency approved/allowed within time … |
CO | 222 | View → |
| HMSC | HMS WILL RECOUP DUE TO COB |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 96 | View → |
| HPCF | HFS - member was not found on Patient Credit File (PCF), therefore services are denied. |
MA43
Missing/incomplete/invalid patient status. |
CO | 177 | View → |
| HPPE | SERVICE NOT PAYABLE WHEN BILLED ON THE SAME CLAIM AS HOSPICE PRE-ELECTION EVAULATION AND COUNSELING. |
N20
Service not payable with other service rendered on the… |
CO | 97 | View → |
| HSPE | PAYMENT IS MADE FOR ONLY ONE CATEGORY OF HOSPICE CARE ON A PARTICULAR DAY. |
N640
Exceeds number/frequency approved/allowed within time … |
CO | 222 | View → |
| I10 | PLACE OF SERVICE MAY BE INAPPROPRIATE FOR TREATMENT. |
M77
Missing/incomplete/invalid/inappropriate place of serv… |
CO | 5 | View → |
| I14 | PROCEDURE IDENTIFIED AS EXCLUSIVE WITH ANOTHER PROCEDURE. PATIENT IS NOT RESPONSIBLE FOR BALANCE. | — | CO | 231 | View → |
| I15 | PROCEDURE IDENTIFIED AS INCIDENTAL TO ANOTHER PROCEDURE. PATIENT IS NOT RESPONSIBLE FOR BALANCE. |
N19
Procedure code incidental to primary procedure. |
CO | 97 | View → |
| I16 | CPT/HCPC CODE IS UNLISTED. PLEASE RESUBMIT WITH VALID CODE. PLEASE INCLUDE COPY OF INVOICE IF APP… |
M81
You are required to code to the highest level of speci… |
CO | 189 | View → |
| I5 | CPT TO ANESTHESIA CROSSWALK CANNOT BE DETERMINED WITHOUT DOCUMENTATION. PLEASE RESUBMIT. |
M51
Missing/incomplete/invalid procedure code(s). |
CO | 16 | View → |
| I7 | PROCEDURE IS TYPICALLY ELECTIVE IN NATURE. |
N130
Consult plan benefit documents/guidelines for informat… |
CO | 204 | View → |
| IA11 | ASSISTANT SURGEON NOT REQUIRED FOR THIS PROCEDURE. | — | CO | 54 | View → |
| IA51 | THE T1015 ENCOUNTER CODE MUST BE BILLED FIRST IN SEQUENCE. | — | CO | 16 | View → |
| IAD | INVALID ADMIT DIAGNOSIS. |
MA65
Missing/incomplete/invalid admitting diagnosis. |
CO | 16 | View → |
| IAD1 | The Admit Diagnosis code is invalid and not found on the table of valid ICD-9 CM Codes. |
MA65
Missing/incomplete/invalid admitting diagnosis. |
CO | 16 | View → |
| IAD2 | The Admit Diagnosis code is invalid: Invalid code, unnecessary 4th/5th digit. |
MA65
Missing/incomplete/invalid admitting diagnosis. |
CO | 16 | View → |
| IAD3 | The Admit Diagnosis code is invalid: missing 4th/5th digit. |
MA65
Missing/incomplete/invalid admitting diagnosis. |
CO | 16 | View → |
| IAD4 | Admit Diagnosis code invalid: Code invalid; found on ICD-9-CM table, but not valid for patient's ad… |
MA65
Missing/incomplete/invalid admitting diagnosis. |
CO | 16 | View → |
| IAD5 | The Admit Diagnosis code is invalid: Invalid code for date of admission, unnecessary 4th/5th digit. |
MA65
Missing/incomplete/invalid admitting diagnosis. |
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.