Skip to main content
Call
RARC N104 · Remittance Advice Remark Code

RARC N104 Remark Code: This claim/service is not payable under our claims jurisdiction area. You can i…

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Updated

Not an ICD-10 code. RARC N104 is a remittance-advice remark code published by X12 and carried on the 835 LQ segment. Any ICD-10 code with the same letters and digits (e.g., ICD-10 M15 osteoarthritis, N130 other urinary tract disorders) is a separate, unrelated code set used in diagnoses on the 837. Confirm the context before acting on this page.

TL;DR

RARC N104 (X12 This claim/service is not payable under our claims jurisdiction area. You can identify the correct…). Commonly paired with CARC 16, CARC 109. RARC N104 indicates the Medicare MAC/jurisdiction is wrong — use the CMS MAC jurisdiction lookup and rebill to the correct contractor.

Official X12 description

“This claim/service is not payable under our claims jurisdiction area. You can identify the correct Medicare contractor to process this claim/service through the CMS website.”

Source: X12 Remittance Advice Remark Codes. X12 publishes and maintains the RARC set; always verify against the current release before building a claim workflow.

Paired CARC codes

RARC N104 almost never appears alone — it accompanies one of the CARCs below on the same 835 remittance line. Fix the CARC and the RARC typically clears; the RARC alone is informational.

Paired CARCWhat the CARC means
CARC 16Claim/service lacks information or has submission/billing error(s).
CARC 109Claim/service not covered by this payer/contractor. You must send the claim/service to the correct payer/contractor.
CARC 226Information requested from the Billing/Rendering Provider was not provided or was insufficient/incomplete.
CARC B11The claim/service has been transferred to the proper payer/processor for processing. Claim/service not covered by this payer/processor.

What RARC N104 actually means

RARC N104 indicates the Medicare MAC/jurisdiction is wrong — use the CMS MAC jurisdiction lookup and rebill to the correct contractor.

Common root causes

  • Wrong MAC for the service state/type.

Prevention checklist

  • MAC-jurisdiction matrix.

Resolution & appeal strategy — step by step

Because RARC N104 is supplemental to a CARC, the resolution path usually starts by fixing the underlying adjustment reason. A formal appeal of the RARC alone is rarely necessary.

  1. 1Rebill correct MAC.
Sample reconsideration language referencing RARC N104
[Provider letterhead] Re: Reconsideration — Claim #{claim_number}, CARC 16 / RARC N104 Member: {member_name} · Member ID: {member_id} Date(s) of Service: {dos} The 835 remittance on {remittance_date} carried RARC N104: "This claim/service is not payable under our claims jurisdiction area. You can identify the correct Medicare contractor to process this claim/service through the CMS website." We request reconsideration. The attached documentation rebuts the remark code: 1. [State the fact that rebuts the remark — authorization number, primary 835, modifier rationale, LCD citation, etc.] 2. [Reference the paired CARC and the corresponding fix] 3. [Attach the supporting document listed in step 1] Attached: {list supporting documents} Please process this line under the member's benefits. Contact the billing office at {provider_phone} for questions. Sincerely, {billing_manager_name}, {credentials}

Edit the bracketed fields before sending. Payer-specific reconsideration forms are often required — check the provider portal first.

How common is RARC N104?

Platform frequency
Pending ETL

Platform frequency ranks publish once the anonymized denial-rate pipeline reaches the publication threshold (strategy §12 Phase 2).

How QuickRCM handles RARC N104

QuickRCM reads RARC N104 alongside its paired CARC in the 835 LQ segment and routes the line to the correct worker queue with the right documentation already attached:

  • Denial routing rules tuned to the CARC+RARC pair — the paired combination tells QuickRCM which documentation the payer will accept.
  • Reconsideration template for this exact remark code pulls the supporting facts from the claim automatically.
  • Pre-submission scrubs that catch the preventable drivers surfaced on this page before the 837 leaves the clearinghouse.
See QuickRCM →Book a demo

Frequently asked questions — RARC N104

What does RARC N104 mean?

RARC N104 is an X12 Remittance Advice Remark Code. The official X12 definition is: "This claim/service is not payable under our claims jurisdiction area. You can identify the correct Medicare contractor to process this claim/service through the CMS website." It is supplemental to a Claim Adjustment Reason Code (CARC) on the same 835 line.

Which CARC is paired with RARC N104?

RARC N104 is most commonly paired with CARC 16, CARC 109, CARC 226, CARC B11. The CARC is the financial adjustment reason; the RARC is the informational remark. Fix the paired CARC first — the RARC usually clears with the corrected claim.

How do I resolve a RARC N104 remark on a remit?

Start from the root cause: Wrong MAC for the service state/type. First step: Rebill correct MAC. Because RARCs are supplemental, the resolution is almost always to address the paired CARC rather than appeal the RARC alone.

Where does RARC N104 appear on the 835 ERA?

RARC N104 is carried on the 835 Loop 2110 LQ segment alongside the CARC in the CAS segment of the same service line. The code and its X12 description also print on the paper EOB in the "Remark Code" or "Remark" column next to the corresponding denial or adjustment reason.

Is RARC N104 the same as ICD-10 code N104?

No. RARC N104 is a remittance-advice remark code published by X12 and carried on the 835. Any ICD-10 code with the same letters and digits is a diagnosis code on the 837 HI segment — a completely different code set maintained by the WHO/CMS. Use the transaction context (835 = RARC; 837 = ICD-10) to disambiguate.

Disclaimer

This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. X12 code descriptors are maintained by the X12 External Code Lists; always verify against the current X12 release and the payer's own published policy before submitting or appealing a claim.