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MA60 Remark Code: Invalid Patient Relationship to Insured

MA60 means the patient's relationship to the insured, such as self, spouse, or child, is missing, incomplete, or invalid. The payer uses the relationship to match the patient to the policyholder's coverage, and could not do so with the value reported.

Quick facts

Code
MA60 (RARC MA60)
Status
Active In use since January 1, 1997; last modified February 28, 2003.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The provider must correct the relationship code. A claim returned over this data error is not billable to the patient.
Official description
Missing/incomplete/invalid patient relationship to insured.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What MA60 means

A health plan covers the policyholder and their eligible dependents. To find the right coverage record, the payer needs to know how the patient relates to the insured. MA60 says that relationship was missing or did not make sense, for example a child relationship with the patient’s own member ID, or a self relationship when the names differ.

It is a data-quality issue, but it can also reveal a true eligibility problem when the patient is not on the policy.

Common causes

  • Box 6 was left blank.
  • A self relationship was chosen, but the insured fields contain someone else.
  • A spouse or child relationship was used with the patient’s own ID number.
  • The relationship changed, for example after divorce or a child aging out, and registration was not updated.

How to fix it

  1. Check the eligibility response for how the patient is listed on the policy.
  2. Correct box 6 and make sure the insured’s name, ID, and date of birth match.
  3. Resubmit the corrected claim, using resubmission code 7 in box 22 if replacing a processed claim.
  4. Contact the payer if the patient does not appear as a dependent at all.

How to prevent it

Record both the patient and the insured separately at registration, and confirm the relationship against the eligibility response. More on coverage-matching problems is in eligibility and COB denials.

Codes that may appear with MA60

  • CO-16 (Claim/service lacks information or has submission/billing error(s).): Claim data is missing or invalid, with MA60 pointing to the patient relationship.
  • CO-32 (Our records indicate the patient is not an eligible dependent.): Payer records show the patient is not an eligible dependent.
  • CO-31 (Patient cannot be identified as our insured.): The patient cannot be identified as the payer's insured.
  • MA36 (Missing/incomplete/invalid patient name.): The patient name is missing or invalid.
  • MA27 (Missing/incomplete/invalid entitlement number or name shown on the claim.): The entitlement number or name is missing or invalid.
  • MA48 (Missing/incomplete/invalid name or address of responsible party or primary payer.): The responsible party or primary payer name or address is missing or invalid.

MA60 FAQ

Where is the relationship reported?

Box 6 on the CMS-1500. Electronic claims report it in the subscriber or patient loop.

What if the patient is the insured?

Mark the relationship as self. In that case the patient information is generally reported in the subscriber loop only on electronic claims.

Could MA60 mean the dependent is not covered?

It can accompany a coverage problem. If CARC 32 appears too, confirm with the payer whether the patient is on the policy at all.