Skip to main content

N138 Remark Code: Second Dental Advisor Review

N138 is an alert that if you disagree with the Dental Advisor's opinion and have additional information about the case, you may submit radiographs to the Dental Advisor Unit at the subscriber's dental carrier for a second, independent Dental Advisor review.

Quick facts

Code
N138 (RARC N138)
Status
Active In use since October 31, 2002; last modified April 1, 2007.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): If the advisor's opinion reduced or denied the service as provider liability, the second review is the route to challenge it.
  • PR (Patient Responsibility): If the patient was left responsible, a successful second review could change what the patient owes.
Official description
Alert: In the event you disagree with the Dental Advisor's opinion and have additional information relative to the case, you may submit radiographs to the Dental Advisor Unit at the subscriber's dental insurance carrier for a second Independent Dental Advisor Review.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N138 means

Dental carriers often send claims for major treatment to a Dental Advisor, a dentist who reviews radiographs and records to decide whether the procedure is supported. N138 accompanies that kind of decision and explains how to get a fresh look: provide radiographs and any new information to the carrier’s Dental Advisor Unit for a second, independent review.

What to do

  1. Read the reason code to see what the advisor decided, such as a denial or an alternate benefit.
  2. Decide whether you have new information. A second review is most useful when the first advisor lacked clear images or clinical detail.
  3. Send diagnostic-quality radiographs and a brief narrative explaining why the treatment was needed.
  4. Track the outcome, and inform the patient if their share changes.

Images that are clear, labeled, and dated, along with a short narrative on the original claim, often prevent the first unfavorable review.

Codes that may appear with N138

  • CO-216 (Based on the findings of a review organization or the payer's findings.): The decision was based on the findings of a review organization or the payer's own review, here the Dental Advisor.
  • CO-169 (Alternate benefit has been provided.): An alternate benefit was provided, a frequent outcome of dental advisor review.
  • CO-150 (Payer deems the information submitted does not support this level of service.): The information submitted does not support this level of service.
  • N10 (Adjustment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review.): Reports an adjustment based on a review organization, professional consult, or dental advisor.
  • N139 (Alert: Under 32 CFR 199.13, a non-participating provider is not an appropriate appealing party.): Covers appeal rights for non-participating providers under the TRICARE dental program rules.
  • N140 (Alert: You have not been designated as an authorized OCONUS provider therefore are not considered an appropriate appealing party.): Covers appeal rights for providers who are not authorized OCONUS providers.

N138 FAQ

What should I send with the radiographs?

Any information the advisor did not have: diagnostic-quality images, periodontal charting, narratives, or photographs that support the treatment.

Is the second review a formal appeal?

The remark describes it as a second independent Dental Advisor review. Ask the carrier whether it counts as an appeal level and whether other appeal rights remain afterward.

Is there a deadline?

N138 does not state one. Ask the carrier and submit promptly.