> ## Documentation Index
> Fetch the complete documentation index at: https://mso.getlemma.com/llms.txt
> Use this file to discover all available pages before exploring further.

# RARC codes (Remittance Advice Remark Codes)

> The high-frequency N-series and M-series remark codes, and how RARCs qualify CARCs.

**Remittance Advice Remark Codes (RARCs)** provide additional explanation for an adjustment, or convey information that doesn't fit a CARC. They appear in the `LQ` segment of the 835.

RARCs are maintained by CMS on behalf of the industry and the list is updated periodically. This page covers the high-frequency working set. The authoritative list is published at [x12.org/codes/remittance-advice-remark-codes](https://x12.org/codes/remittance-advice-remark-codes) — check it for codes not listed here and for current definitions.

## What RARCs do

Two types:

| Type              | Prefix                             | Purpose                                                 |
| ----------------- | ---------------------------------- | ------------------------------------------------------- |
| **Supplemental**  | `M`, `N`                           | Explains an adjustment further, always alongside a CARC |
| **Informational** | `Alert:` prefix in the description | Conveys information without an adjustment               |

**The RARC is what makes a vague CARC actionable.** CARC 16, "claim lacks information", is a scavenger hunt on its own. CARC 16 with a RARC telling you *which* information is missing is a five-minute fix.

<Tip>
  **Train billers to read the RARC before working a CARC 16, 96, 125, or 252.** Those CARCs are deliberately generic; the RARC carries the specifics.
</Tip>

## High-frequency N-series

| RARC     | Meaning                                                                                                                                       |
| -------- | --------------------------------------------------------------------------------------------------------------------------------------------- |
| **N4**   | Missing/incomplete/invalid prior insurance carrier EOB                                                                                        |
| N19      | Procedure code incidental to the primary procedure                                                                                            |
| N20      | Service not payable with other service rendered the same day                                                                                  |
| N30      | Patient ineligible for this service                                                                                                           |
| N54      | Claim information is inconsistent with pre-certified/authorized services                                                                      |
| N56      | Procedure code billed is not correct/valid for the services billed or the date of service                                                     |
| **N130** | Consult plan benefit documents/guidelines for information about restrictions                                                                  |
| N179     | Additional information has been requested from the member                                                                                     |
| N180     | This item or service does not meet the criteria for the category under which it was billed                                                    |
| **N192** | Patient is a Medicaid/Qualified Medicare Beneficiary                                                                                          |
| **N210** | You may appeal this decision                                                                                                                  |
| **N211** | You may not appeal this decision                                                                                                              |
| N290     | Missing/incomplete/invalid rendering provider primary identifier                                                                              |
| N291     | Missing/incomplete/invalid rendering provider secondary identifier                                                                            |
| **N347** | Your claim for a referred or purchased service cannot be paid because payment has already been made for this same service to another provider |
| N362     | The number of days or units of service exceeds our acceptable maximum                                                                         |
| N381     | Consult our contractual agreement for restrictions/billing/payment information                                                                |
| N418     | Misrouted claim, see the payer's claims submission instructions                                                                               |
| N448     | This drug/service/supply is not included in the fee schedule or contracted/legislated fee arrangement                                         |
| N522     | Duplicate of a claim processed or in process as a crossover/coordination of benefits claim                                                    |
| N657     | This should be billed with the appropriate code for these services                                                                            |

## High-frequency M-series

| RARC     | Meaning                                                                                                                        |
| -------- | ------------------------------------------------------------------------------------------------------------------------------ |
| **M15**  | Separately billed services/tests have been bundled as they are considered components of the same procedure                     |
| M20      | Missing/incomplete/invalid HCPCS                                                                                               |
| M25      | The information furnished does not substantiate the need for this level of service                                             |
| M51      | Missing/incomplete/invalid procedure code(s)                                                                                   |
| **M54**  | Missing/incomplete/invalid total charges                                                                                       |
| M67      | Missing/incomplete/invalid other procedure code(s)                                                                             |
| M76      | Missing/incomplete/invalid diagnosis or condition                                                                              |
| **M77**  | Missing/incomplete/invalid/inappropriate place of service                                                                      |
| M79      | Missing/incomplete/invalid charges on the claim                                                                                |
| **M80**  | Not covered when performed during the same session/date as a previously processed service for the patient                      |
| M81      | You are required to code to the highest level of specificity                                                                   |
| M119     | Missing/incomplete/invalid national drug code                                                                                  |
| M127     | Missing patient medical record for this service                                                                                |
| MA04     | Secondary payment cannot be considered without the identity of, or payment information from, the primary payer                 |
| **MA13** | Alert: you may be subject to penalties if you bill the patient for amounts not reported with patient responsibility group code |
| MA61     | Missing/incomplete/invalid Social Security number or health insurance claim number                                             |
| MA130    | Your claim contains incomplete and/or invalid information; no appeal rights, submit a new claim                                |

<Warning>
  **MA130 is important and misread constantly.** It means the claim was rejected as incomplete with **no appeal rights** — submit a new claim rather than an appeal. Practices that appeal MA130 waste the effort and may run out the filing window.

  **MA13** is a warning that billing the patient for a non-PR amount can carry penalties. If you see it, check your group code mapping.
</Warning>

## Appeal rights signals

Two RARCs tell you directly whether an appeal is available:

| RARC      | Meaning                                                      |
| --------- | ------------------------------------------------------------ |
| **N210**  | **You may appeal this decision**                             |
| **N211**  | **You may not appeal this decision**                         |
| **MA130** | Incomplete/invalid, **no appeal rights**; submit a new claim |

Reading these first saves filing appeals that cannot succeed.

## Working with RARCs

<Steps>
  <Step title="Always read the RARC before working a generic CARC">
    CARC 16, 96, 125, and 252 are generic by design.
  </Step>

  <Step title="Check for appeal-rights RARCs">
    N210, N211, MA130 determine whether an appeal is even available.
  </Step>

  <Step title="Include the RARC in your denial root-cause tagging">
    "CARC 16" is not a root cause. "CARC 16 / N290, missing rendering provider NPI" is.
  </Step>

  <Step title="Look up anything unfamiliar before posting">
    Do not guess at a RARC's meaning. The authoritative list is public.
  </Step>
</Steps>


## Related topics

- [The 835: how payers answer](/concepts/payments/understanding-835s.md)
- [Claim denials, explained](/concepts/payments/claim-denials.md)
- [Work the denial queue](/guides/billing/work-the-denial-queue.md)
- [Post payments from 835s](/guides/billing/post-payments-from-835s.md)
- [CARC codes (Claim Adjustment Reason Codes)](/reference/edi/carc-codes.md)
- [Group codes (CO, PR, OA, PI)](/reference/edi/group-codes.md)
- [Denial code playbook](/reference/edi/denial-code-playbook.md)