Healthcare Error Code
Healthcare Insurance / Medical Billing
Remittance Advice Remark Codes (RARC)
N95 | Benefits adjusted
Industry
Healthcare
Canonical
/healthcare/error-codes/n95/
Last Updated
Feb 25, 2026
Summary
This code indicates that benefits were adjusted according to payer rules.
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What This Code Means
N95 is used to note that an adjustment was applied to the claim based on benefit calculations. It provides clarification but does not independently determine coverage. Adjustments may relate to coordination of benefits, contractual terms, or cost-sharing. The code does not specify the reason for adjustment on its own.
Where Users Usually See This Code
- Remittance advice remark fields
- EOB summaries
- Claim adjustment details
Why This Code Appears
- Coordination of benefits applied
- Contractual or benefit calculations adjusted
- Cost-sharing rules enforced
What Typically Happens Next
- Adjusted payment is finalized
- Claim processing is complete
- Balances are updated accordingly
What This Code Is Not
- It is not a denial
- It is not a billing error
- It is not patient responsibility by itself
Troubleshooting Checklist
- □ Review benefit calculations
- □ Confirm coordination of benefits
- □ Monitor EOB adjustments
Notes And Edge Cases
Multiple adjustments may apply to a single claim. Different benefit layers can affect final amounts.
Related Codes
8 links
- CO-151 CodePayment adjusted due to contractual agreement
- PR-1 CodeDeductible amount
- N94 CodeProcessed in excess of charges
- CO-141 CodeClaim adjusted by payer
- N153 CodeAdjustment based on coverage
- CO-11 CodeDiagnosis inconsistent with procedure
- CO-65 CodeProcedure code invalid
- M184 CodeIncorrect patient
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