Official X12 description
“Incomplete/invalid plan information for other insurance.”
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 N245 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 CARC | What the CARC means |
|---|---|
| CARC 22 | This care may be covered by another payer per coordination of benefits. |
| CARC 23 | The impact of prior payer(s) adjudication including payments and/or adjustments. |
| CARC 24 | Charges are covered under a capitation agreement/managed care plan. |
| CARC 109 | Claim/service not covered by this payer/contractor. You must send the claim/service to the correct payer/contractor. |
| CARC 136 | Failure to follow prior payer's coverage rules. |
What RARC N245 actually means
RARC N245 flags missing/invalid COB information for the other plan. Collect correct other-plan info from the patient or from COB records, then submit a corrected claim.
Common root causes
- Other-plan information not captured on registration.
- COB data stale.
Prevention checklist
- COB refresh workflow at each visit.
- Coordination-of-benefits form signed annually.
Resolution & appeal strategy — step by step
Because RARC N245 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.
- 1Submit corrected COB data and rebill.
Sample reconsideration language referencing RARC N245
Edit the bracketed fields before sending. Payer-specific reconsideration forms are often required — check the provider portal first.
How common is RARC N245?
Platform frequency ranks publish once the anonymized denial-rate pipeline reaches the publication threshold (strategy §12 Phase 2).
How QuickRCM handles RARC N245
QuickRCM reads RARC N245 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.
Frequently asked questions — RARC N245
What does RARC N245 mean?
RARC N245 is an X12 Remittance Advice Remark Code. The official X12 definition is: "Incomplete/invalid plan information for other insurance." It is supplemental to a Claim Adjustment Reason Code (CARC) on the same 835 line.
Which CARC is paired with RARC N245?
RARC N245 is most commonly paired with CARC 22, CARC 23, CARC 24, CARC 109, CARC 136. 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 N245 remark on a remit?
Start from the root cause: Other-plan information not captured on registration. First step: Submit corrected COB data and rebill. Because RARCs are supplemental, the resolution is almost always to address the paired CARC rather than appeal the RARC alone.
Where does RARC N245 appear on the 835 ERA?
RARC N245 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 N245 the same as ICD-10 code N245?
No. RARC N245 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.