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N103 Remark Code: Patient in Custody on Date of Service

N103 means the payer's records show the patient was a prisoner or in the custody of a federal, state, or local authority on the date of service. The payer does not cover care furnished during custody except in narrow circumstances, and the provider may be able to collect from the custodial authority instead.

Quick facts

Code
N103 (RARC N103)
Status
Active In use since October 31, 2001; last modified November 1, 2013.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The payer will not pay because of the custody status. The provider should look to the custodial authority, not the patient's plan.
  • OA (Other Adjustment): Some payers report the custody exclusion as an other adjustment; the practical effect is the same.
Official description
Records indicate this patient was a prisoner or in custody of a Federal, State, or local authority when the service was rendered. This payer does not cover items and services furnished to an individual while he or she is in custody under a penal statute or rule, unless under State or local law, the individual is personally liable for the cost of his or her health care while in custody and the State or local government pursues the collection of such debt in the same way and with the same vigor as the collection of its other debts. The provider can collect from the Federal/State/ Local Authority as appropriate.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N103 means

Public programs such as Medicare generally do not pay for services to people in custody under a penal statute, because the custodial government is responsible for their care. N103 tells you the payer’s records, typically fed by government data, show the patient was in custody on the date of service.

It usually appears with CARC 258. The remark also notes that the provider may be able to collect from the federal, state, or local authority that had custody.

Common causes

  • The patient was treated while incarcerated or under arrest, for example in an emergency department with guards present.
  • The patient was released, but the release date had not reached the payer’s records.
  • The patient was in a custody status such as a halfway house or supervised release that the payer’s data treats as custody.
  • An identity mix-up linked the claim to the wrong person’s record.

What to do

  1. Confirm the patient’s status on the date of service. Registration notes, intake forms, or the patient’s own account can help.
  2. If the patient was in custody, bill the responsible authority using its process. Many correctional systems have contracted claims administrators.
  3. If the patient had been released, get documentation of the release date. Ask the payer how to correct its records; some direct the patient to the agency that maintains entitlement data.
  4. Request reprocessing or appeal once the record is corrected, and track the claim against timely filing limits. See the timely filing guide.

How to prevent it

At registration, ask whether the patient arrived from or is in the custody of a law enforcement or correctional agency, and capture the agency’s billing details at that time. Flag these accounts so they are not sent to the patient’s health plan by default.

Codes that may appear with N103

  • CO-258 (Claim/service not covered when patient is in custody/incarcerated.): Claim/service not covered when the patient is in custody or incarcerated; N103 is the detailed explanation.
  • CO-96 (Non-covered charge(s).): A general non-covered charge where N103 gives the reason.
  • N126 (Social Security Records indicate that this individual has been deported.): A different government-records exclusion, used when the individual has been deported.
  • CO-177 (Patient has not met the required eligibility requirements.): The patient did not meet eligibility requirements, a broader eligibility denial.
  • CO-109 (Claim/service not covered by this payer/contractor.): Not covered by this payer; send the claim to the correct payer or contractor.

N103 FAQ

Who pays for care when the patient was in custody?

Usually the custodial authority, such as the correctional facility or the agency responsible for the person. Contact that authority for its billing process.

What if the patient was not actually in custody?

Records can be wrong or out of date, for example when release dates were not reported. Ask the patient for proof of release and contact the payer about correcting the record, then request reprocessing.

Is there any exception?

The official remark describes one: where state or local law makes the individual personally liable for their care while in custody and the government actually pursues that debt like its other debts. Whether it applies depends on the jurisdiction.