RARC N16Supplemental
The patient has met their out-of-pocket maximum for the plan year, so cost-sharing no longer applies.
This code supplements the claim adjustment reason (CARC) code it accompanies with more detail about why the adjustment was made.
Related Supplemental codes
M1There isn't a current enough X-ray on file to support this service, based on the payer's timing requirements.M119The claim was missing a valid National Drug Code.M123The claim was missing the drug's strength or dosage information.M124The claim was missing information about whether the patient owns or is renting the equipment billed.M125The claim was missing the expected duration for this service or supply.M126The claim was missing individual, itemized lab test codes rather than a panel code.M127The claim was missing supporting medical record documentation.M129The claim was missing an indicator of whether X-rays are available for review.
Frequently asked questions
What does RARC N16 mean?
The patient has met their out-of-pocket maximum for the plan year, so cost-sharing no longer applies.
Is RARC N16 a supplemental or alert code?
N16 is a Supplemental code — it adds detail to the claim adjustment reason (CARC) code it accompanies.
CARC codes maintained by X12 (x12.org). Descriptions on this site are original reference interpretations. RARC codes maintained by CMS. Always verify codes with authoritative sources before making billing decisions.