Look up another code

N119 Remark Code: 28-Day Service With Inpatient/SNF Stay

N119 means the service, which is billed once every 28 days, is not paid because the patient spent five or more consecutive days as an inpatient or in a skilled nursing facility (SNF) during that 28-day period. The facility stay affects whether the periodic service is payable.

Code: N119 (RARC N119)
Status: Active In use since July 30, 2002; last modified June 30, 2003.
Code set: Remittance Advice Remark Codes (RARC)
Group codes: CO (Contractual Obligation): The provider generally absorbs the amount; the patient is not billed unless they accepted liability in advance.
Official description: This service is not paid if billed once every 28 days, and the patient has spent 5 or more consecutive days in any inpatient or Skilled /nursing Facility (SNF) within those 28 days.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What N119 means

N119 combines two conditions. The service is one that is billed on a 28-day cycle, and during that cycle the patient was in a hospital as an inpatient or in a skilled nursing facility for at least five consecutive days. When both are true, the payer will not pay the periodic service for that cycle.

The reasoning is that someone in a facility for a large portion of the period was being cared for by that facility, so paying an outside provider for the whole cycle would double-pay.

Common causes

The practice billed the full cycle without knowing the patient had been admitted.
The patient was admitted and discharged during the cycle, and the dates were not tracked.
Facility stay dates on the payer’s file are wrong, making a shorter stay appear to be five or more days.
The service was billed for a period that overlaps two cycles, pulling in a stay from the earlier one.

What to do

Get the admission and discharge dates of any inpatient or SNF stay in the 28-day period.
Count consecutive days and check them against the service period on your claim (CMS-1500 box 24A).
If the stay was shorter or outside the period, appeal or request reprocessing with the facility’s dates as evidence.
If the billing period was wrong, correct it with a replacement claim (resubmission code 7 in box 22 and the original claim number).
If the rule applies, adjust the balance off according to the group code.

How to prevent it

Ask patients at each contact whether they have been hospitalized or in a nursing facility since the last cycle. For services billed on a 28-day basis, hold the claim until the cycle ends and confirm there was no qualifying stay.

Codes that may appear with N119

PR-119 (Benefit maximum for this time period or occurrence has been reached.): The benefit for this time period is not available under the payer's rules.
CO-190 (Payment is included in the allowance for a Skilled Nursing Facility (SNF) qualified stay.): Payment is included in the allowance for a qualified SNF stay.
CO-96 (Non-covered charge(s).): A non-covered charge, with N119 describing the facility-stay condition.

N118 (This service is not paid if billed more than once every 28 days.): The simpler rule: the service is not paid more than once every 28 days.
N106 (Payment for services furnished to Skilled Nursing Facility (SNF) inpatients (except for excluded services) can only be made to the SNF.): Payment for services to SNF inpatients can only be made to the SNF.
N121 (Medicare Part B does not pay for items or services provided by this type of practitioner for beneficiaries in a Medicare Part A covered Skilled…): Part B does not pay this practitioner type during a covered SNF stay.

N119 FAQ

Why would a hospital or SNF stay affect my service?

When the patient is in a facility for an extended stretch, the facility is often responsible for much of the patient's care, and the payer treats the periodic service as not separately payable for that cycle.

Do the five days have to be in a row?

Yes. The official remark refers to five or more consecutive days. Shorter, separate stays do not meet the condition as written.

How do I find the facility dates?

Ask the patient or the facility, and check the payer's eligibility response, which may show recent inpatient or SNF stays.

Important: read before using this information

This page is general educational information about a standard industry code set. It is not medical billing, coding, legal, reimbursement, or compliance advice, and it does not create a professional or advisory relationship with ClaimsRevenue.

Code definitions, payer usage, contracts, and laws change, and payers may apply the same code differently. The information is provided “as is,” without warranties of any kind, express or implied, including accuracy, completeness, or currency. You are solely responsible for verifying it against the current official X12 code lists, CMS guidance, your payer contracts, and payer policies before relying on it, and for every billing, coding, collection, and appeal decision you make.

Using this information does not guarantee that any claim will be paid or that any appeal will succeed. To the fullest extent permitted by law, ClaimsRevenue and MOODRX LLC are not liable for any loss or damage arising from its use. Official code descriptions are published by X12 and are quoted for reference only. See our full Claims Validation Disclaimer.