Products
Clarity Flow
Accurate patient cost estimate software that stimulates upfront payments and complies with price transparency regulations.
RevFind
Underpayment detection and contract optimization software that ingests your contract terms and identifies opportunities for net revenue uplift when payers stiff you.
Use Cases
Detect Underpayments
Identify revenue opportunities from payer underpayments down to the claim level.
Increase Upfront Collections
Avoid write-offs by collecting from patients earlier in the AR cycle.
Comply with Good Faith Estimates
Automate creation and delivery of accurate patient estimates to adhere to transparency rules.
Evaluate Contract Performance
Measure and compare managed care contract performance for better negotiation outcomes.
Optimize Your Chargemaster
Correct chargemaster rates that fall short of contracted rates to maximize revenue.
Track Underpayment Recovery
Uncover which payers respond most quickly and fully to reimbursement demands.
Manage Denials
Jumpstart your appeals and denials prevention processes by automating denials management.
Model Potential Contract Rate Changes
Model the impact of contract proposals on revenue during negotiations with payers.
Integrations
Resources
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Learn the latest on healthcare transparency policy and trends in revenue cycle management.
Case Studies
Read real stories of how providers have achieved success with MD Clarity.
Guides
Get in-depth knowledge through our comprehensive handbooks on specific regulations and revenue cycle applications.
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(800) 205-4675
[email protected]
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Denial Code (RARC) List
Overwhelmed by RARCs? Get up to speed with our list of remark codes.
RARC #
Remittance Advice Remark Code Description
N170
Remark code N170 indicates that a current certificate of medical necessity must be updated or replaced for billing.
N171
Remark code N171 indicates that payment for repair or replacement is not covered or exceeds the item's original cost.
N172
Remark code N172 indicates that the patient is not responsible for payment of denied or adjusted charges for updated services or items.
N173
Remark code N173 indicates that claim processing is incomplete due to missing hospital stay dates for the care episode.
N174
Remark code N174 indicates a service or item isn't covered, but patient financial responsibility is capped at the adjustment amount listed under 'PR'.
N175
Remark code N175 indicates a claim denial due to the absence of necessary approval from the review organization.
N176
Remark code N176 indicates coverage for services on a US-registered ship is limited to when it's in US waters and provided by a US-licensed doctor.
N177
Remark code N177 indicates a claim wasn't sent to the secondary insurer as no further payment is expected from them.
N178
Remark code N178 indicates a claim denial due to missing pre-operative images or visual field results required for processing.
N179
Remark code N179 indicates that further details are needed from the patient for claim reconsideration.
N180
Remark code N180 indicates an item or service doesn't meet the billing category criteria. Ensure correct coding to avoid claim denials.
N181
Remark code N181 indicates that further details are needed from a different provider who participated in the service for billing.
N182
Remark code N182 indicates that the claim/service must adhere to the specific billing schedule of the patient's insurance plan.
N183
Remark code N183 indicates a predetermination advisory, signaling that extra documentation will be needed to process benefits when the service is billed.
N184
Remark code N184 indicates that providers must rebill technical and professional components of a service as separate claims.
N185
Remark code N185 indicates that the claim/service should not be resubmitted as it has been processed and further action is not required.
N186
Remark code N186 indicates a Non-Availability Statement (NAS) is needed for the service and advises contacting a Military Treatment Facility.
N187
Remark code N187 indicates a review request can be made within the specified time after notice receipt per contract or plan documents.
N188
Remark code N188 indicates the procedure code submitted doesn't align with the approved care level.
N189
Remark code N189 indicates a one-time exception payment for a service not typically covered under the plan's benefits.
N19
Remark code N19 indicates that the billed service is considered incidental to the primary procedure performed.
N190
Remark code N190 indicates a claim was rejected due to a missing contract indicator, which is essential for processing.
N191
Remark code N191 indicates that the provider needs to update insurance details directly with the insurance payer for claims processing.
N192
Remark code N192 indicates that the patient has Medicaid or is a Qualified Medicare Beneficiary, impacting billing.
N193
Remark code N193 indicates a service may be covered by a specific federal, state, or local program, suggesting an alternate payer.
N194
Remark code N194 indicates denial of payment for technical components when the provider doesn't own the equipment utilized.
N195
Remark code N195 indicates that the technical part of a service must be billed independently from the professional component.
N196
Remark code N196 indicates that the patient may have other insurance coverage that should be considered primary.
N197
Remark code N197 indicates that the subscriber needs to provide updated insurance details directly to the insurance payer.
N198
Remark code N198 indicates that the billing provider must be associated with the listed pay-to provider for claim payment.
N199
Remark code N199 indicates a payer has approved extra payment or recoupment following their review or audit.
N2
Remark code N2 indicates an allowance adjustment based on the plan's most appropriate treatment provision.
N20
Remark code N20 indicates a service isn't payable when billed with another service on the same date.
N200
Remark code N200 indicates that the professional part of a service must be billed separately for accurate payment.
N202
Remark code N202 indicates that further details or explanations will be provided in a separate communication.
N203
Remark code N203 indicates an error due to missing, incomplete, or invalid anesthesia time or units on a claim.
N204
Remark code N204 indicates a service is being reviewed for a pre-existing condition; providers must submit the past year's medical records.
N205
Remark code N205 indicates that the information submitted was not readable and needs clarification for processing.
N206
Remark code N206 indicates that the documentation provided doesn't align with the claim details, potentially affecting reimbursement.
N207
Remark code N207 indicates an error due to missing, incomplete, or invalid weight information in a claim submission.
N208
Remark code N208 indicates an issue with the claim due to a missing, incomplete, or invalid Diagnosis-Related Group (DRG) code.
N209
Remark code N209 indicates a claim issue due to a missing, incomplete, or invalid taxpayer identification number.
N21
Remark code N21 indicates that an item on a claim has been split into multiple lines for faster processing.
N210
Remark code N210 indicates a decision that can be appealed by healthcare providers for claim resolution.
N211
Remark code N211 indicates that the decision is final and cannot be appealed by the healthcare provider.
N212
Remark code N212 indicates charges were processed under a Point of Service benefit plan.
N213
Remark code N213 indicates a claim issue due to missing or invalid DRG status info for a specific facility or unit.
N214
Remark code N214 indicates a claim denial due to missing or invalid history of initial surgical procedures.
N215
Remark code N215 indicates that secondary payers won't need a primary payer's claim decision to process their own claim for a service.
N216
Remark code N216 indicates a service isn't covered or the patient isn't enrolled in the relevant benefit package.
N217
Remark code N217 indicates that reimbursement is limited to one service location per provider for each claim submitted.
N218
Remark code N218 indicates that the provider must supply and service an item as long as needed, with maintenance costs covered as per the contract.
N219
Remark code N219 indicates a payment adjustment based on the allowed amount from a previous insurance payer.
N22
Remark code N22 indicates a procedure code update to better reflect services provided, aiding accurate billing and reimbursement.
N220
Remark code N220 indicates a need to visit the payer's website or contact their Customer Service for forms and instructions to file a provider dispute.
N221
Remark code N221 indicates a claim denial due to a missing Admitting History and Physical report.
N222
Remark code N222 indicates an incomplete or invalid Admitting History and Physical report in healthcare claims.
N223
Remark code N223 indicates a claim denial due to missing evidence of patient benefit in the initial treatment period.
N224
Remark code N224 indicates a claim denial due to incomplete or invalid documentation of patient benefit during initial treatment.
N226
Remark code N226 indicates an issue with the ADA Certificate of Recognition, requiring validation or completion for processing.
N227
Remark code N227 indicates an incomplete or invalid Certificate of Medical Necessity on a healthcare claim.
N228
Remark code N228 indicates a claim denial due to an incomplete or invalid consent form submission in the billing process.
N229
Remark code N229 indicates an issue with a claim due to an incomplete or invalid contract indicator in healthcare billing.
N23
Remark code N23 indicates potential changes in patient liability due to benefits coordination with other insurers or benefit caps.
N230
Remark code N230 alerts providers that a claim lacks valid confirmation of patient-owned equipment needing parts or supplies.
N231
Remark code N231 indicates an invalid or incomplete invoice/statement for the cost of a lens or the type of intraocular lens used.
N232
Remark code N232 indicates an incomplete or invalid itemized bill/statement, requiring correction for claim processing.
N233
Remark code N233 indicates an incomplete or invalid operative note/report, requiring action for proper claim processing.
N234
Remark code N234 indicates an incomplete or invalid oxygen certification or re-certification in a claim submission.
N235
Remark code N235 indicates a claim issue due to an incomplete or invalid pacemaker registration form.
N236
Remark code N236 indicates an incomplete or invalid pathology report, requiring review or additional information for claims processing.
N237
Remark code N237 indicates an incomplete or invalid patient medical record for a specific service, requiring action for proper billing.
N238
Remark code N238 indicates a claim was denied due to an incomplete or invalid physician-certified plan of care.
N239
Remark code N239 indicates an issue with a claim due to an incomplete or invalid physician financial relationship form.
N24
Remark code N24 indicates a claim issue due to missing or invalid EFT banking details, requiring action for payment processing.
N240
Remark code N240 indicates a claim denial due to an incomplete or invalid radiology report.
N241
Remark code N241 indicates a claim denial due to incomplete or invalid review organization approval.
N242
Remark code N242 indicates a claim denial due to incomplete or invalid radiology films or images submitted.
N243
Remark code N243 indicates a claim denial due to an incomplete, invalid, or unapproved screening document.
N244
Remark code N244 indicates a claim denial due to incomplete or invalid pre-operative images or visual field results.
N245
Remark code N245 indicates a claim was denied due to incomplete or invalid plan information for other insurance.
N246
Remark code N246 indicates that state-regulated payment limits apply to the billed healthcare service.
N247
Remark code N247 indicates an issue with the assistant surgeon's taxonomy, such as missing or incorrect information.
N248
Remark code N248 indicates a claim issue due to a missing or invalid assistant surgeon's name, requiring correction for processing.
N249
Remark code N249 indicates an issue with the assistant surgeon's primary identifier, such as missing or invalid details.
N25
Remark code N25 indicates a third-party administrator handles claims but doesn't bear financial responsibility for your benefit plan.
N250
Remark code N250 indicates an issue with the assistant surgeon's secondary identifier, such as missing or invalid details.
N251
Remark code N251 indicates an issue with the claim: the attending provider's taxonomy code is missing, incomplete, or invalid.
N252
Remark code N252 indicates an issue with a claim due to a missing or invalid attending provider's name, requiring correction.
N253
Remark code N253 indicates a claim issue due to a missing or invalid attending provider's primary identifier.
N254
Remark code N254 indicates an issue with a missing or incorrect secondary identifier for the attending provider in a claim.
N255
Remark code N255 indicates an issue with the claim due to missing or invalid billing provider taxonomy information.
N256
Remark code N256 indicates an issue with the claim due to a missing or invalid billing provider/supplier name.
N257
Remark code N257 indicates an issue with the billing provider's primary identifier, such as missing or incorrect details.
N258
Remark code N258 indicates an error due to a missing, incomplete, or invalid address for the billing provider or supplier.
N259
Remark code N259 indicates an issue with a secondary identifier for the billing provider/supplier, requiring correction.
N26
Remark code N26 indicates a claim was denied due to a missing itemized bill or statement, requiring submission for processing.
N260
Remark code N260 indicates a claim was denied due to missing or incorrect billing provider contact information.
N261
Remark code N261 indicates an issue with a claim due to a missing or invalid operating provider name.
N262
Remark code N262 indicates an issue with the operating provider's primary identifier, such as it being missing or incorrect.
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