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RARC N67 · Remittance Advice Remark Code

RARC N67 Remark Code: Professional provider services not paid separately. Included in facility paymen…

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Updated

Not an ICD-10 code. RARC N67 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 N67 (X12 Professional provider services not paid separately. Included in facility payment under a demonstrat…). Commonly paired with CARC 97, CARC 132. RARC N67 blocks professional payment under a demo bundle.

Official X12 description

“Professional provider services not paid separately. Included in facility payment under a demonstration project. Apply to that facility for payment, or resubmit your claim if: the facility notifies you the patient was excluded from this demonstration; or if you furnished these services in another location on the date of the patient's admission or discharge from a demonstration hospital. If services were furnished in a facility not involved in the demonstration on the same date the patient was discharged from or admitted to a demonstration facility, you must report the provider ID number for the non-demonstration facility on the new claim.”

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 N67 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 97The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.
CARC 132Prearranged demonstration project adjustment.

What RARC N67 actually means

RARC N67 blocks professional payment under a demo bundle. Seek payment through the facility or resubmit with non-demo location details.

Common root causes

  • Professional charges bundled under demonstration project.

Prevention checklist

  • Demo-project awareness in billing.

Resolution & appeal strategy — step by step

Because RARC N67 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 per demo rules.
Sample reconsideration language referencing RARC N67
[Provider letterhead] Re: Reconsideration — Claim #{claim_number}, CARC 97 / RARC N67 Member: {member_name} · Member ID: {member_id} Date(s) of Service: {dos} The 835 remittance on {remittance_date} carried RARC N67: "Professional provider services not paid separately. Included in facility payment under a demonstration project. Apply to that facility for payment, or resubmit your claim if: the…" 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 N67?

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 N67

QuickRCM reads RARC N67 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.
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Frequently asked questions — RARC N67

What does RARC N67 mean?

RARC N67 is an X12 Remittance Advice Remark Code. The official X12 definition is: "Professional provider services not paid separately. Included in facility payment under a demonstration project. Apply to that facility for payment, or resubmit your claim if: the facility notifies you the patient was excluded from this demonstration; or if you furnished these services in another location on the date of the patient's admission or discharge from a demonstration hospital. If services were furnished in a facility not involved in the demonstration on the same date the patient was discharged from or admitted to a demonstration facility, you must report the provider ID number for the non-demonstration facility on the new claim." It is supplemental to a Claim Adjustment Reason Code (CARC) on the same 835 line.

Which CARC is paired with RARC N67?

RARC N67 is most commonly paired with CARC 97, CARC 132. 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 N67 remark on a remit?

Start from the root cause: Professional charges bundled under demonstration project. First step: Rebill per demo rules. Because RARCs are supplemental, the resolution is almost always to address the paired CARC rather than appeal the RARC alone.

Where does RARC N67 appear on the 835 ERA?

RARC N67 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 N67 the same as ICD-10 code N67?

No. RARC N67 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.