N130
Remittance Advice Remark Code (RARC)
N130 Denial Code: Check the plan's benefit documents for the governing rule
An informational remark code directing you to the plan's benefit documents or coverage guidelines for the rules that affected this service. It supplements a CARC; it is not a standalone denial.
- Group code
- N/A (no group code)
- Code type
- RARC
- Billable to patient?
- N/A - remark code
- Appealable?
- Depends on the paired reason code
- Category
- Coverage & Benefits
On a remittance
LQ*HE*N130Appears as a remark code alongside a claim adjustment reason code.What N130 means
N130 is a Remittance Advice Remark Code (RARC), not a Claim Adjustment Reason Code. It rarely appears alone - it accompanies a CARC (such as CO-45, PR-204, or CO-50) to point you to the specific plan document or guideline behind the adjustment. To act on it, read the paired CARC first, then consult the plan's benefit or policy document for the limitation it references.
Common causes
- The service is subject to a plan-specific limitation, exclusion, or guideline.
- A benefit maximum, frequency limit, or coverage rule applied.
- The payer is pointing you to its medical or benefit policy for the detail behind the paired CARC.
How to fix it
- Identify the CARC paired with N130 on the same line - that is the actionable reason.
- Pull the plan's benefit document or the cited coverage guideline for the specific restriction.
- Resolve based on the paired CARC (correct and resubmit, appeal with documentation, or bill the patient as appropriate).
How to prevent it
- Keep payer benefit and policy references handy for high-volume services.
- Verify plan-specific limits and exclusions during eligibility checks.
- Document the guideline that applies so staff can act on N130 quickly next time.
Depends on the paired reason codeN130 is informational. Whether you can appeal depends entirely on the CARC it is paired with. Read that code's guidance.