Contact Info
Infectious Disease Epidemiology, Prevention and Control Division
651-201-5414
Denial Reason Codes
Medical claim denials are listed on the remittance advice (RA) either as numbers or a combination of letters and numbers. Below are the three most commonly used denial codes:
- Claim status category codes
- Claim adjustment reason codes
- Remittance advice remarks codes
- X12: Claim Status Category Codes
Indicate the general category of the status (accepted, rejected, additional information requested, etc.), which is then further detailed in the Claim Status Codes. - X12: Claim Adjustment Reason Codes
Communicates an adjustment, which means they must communicate why a claim or service line was paid differently than it was billed. If there is no adjustment to a claim, there is no adjustment reason code. - X12: Remittance Advice Remarks Codes
Remittance Advice Remark Codes (RARCs) are used to provide additional explanation for an adjustment already described by a Claim Adjustment Reason Codes (CARC) or to convey information about remittance processing.
Last Updated: 12/05/2023