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N141 Remark Code: Patient Not in Long-Term Care Facility

N141 means the patient was not residing in a long-term care facility during all or part of the service dates billed. The payer denied or reduced the claim for the dates it could not match to a facility stay.

Quick facts

Code
N141 (RARC N141)
Status
Active In use since October 31, 2002.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): Days that cannot be matched to a residency are denied as provider liability until the records are reconciled.
  • PR (Patient Responsibility): Occasionally used when the payer determines the patient, not the program, is responsible for unmatched days.
Official description
The patient was not residing in a long-term care facility during all or part of the service dates billed.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N141 means

Payers that pay for long-term care keep their own record of when a patient entered and left a facility. N141 means some of the dates on your claim fall outside the residency the payer has on file, so those dates were not paid.

The issue is usually a mismatch between the claim and the payer’s admission, discharge, or placement records rather than a coverage question.

Common causes

  • The patient’s admission had not yet been reported to or approved by the program when the claim was processed.
  • The discharge date on the claim was later than the actual discharge, or a hospital transfer interrupted the stay.
  • Leave-of-absence or bed-hold days were billed as residency days without the required codes.
  • The patient moved between facilities, and the payer recorded the move on a different date.

What to do

  1. Pull the facility census for the patient and list the actual in-facility dates.
  2. Compare them with the payer’s records, using the eligibility response or the program’s placement system.
  3. Correct the claim if the dates or leave coding were wrong, and resubmit per the payer’s replacement process.
  4. Update the program’s records if the admission or discharge was never reported, then request reprocessing.

How to prevent it

Report admissions, discharges, transfers, and leave days to the payer promptly, and reconcile the census with the program’s records before billing each period. Hold claims for new admissions until the payer confirms the placement.

Codes that may appear with N141

  • CO-177 (Patient has not met the required eligibility requirements.): The patient did not meet eligibility requirements for the billed dates.
  • CO-96 (Non-covered charge(s).): A non-covered charge for days outside the facility stay.
  • CO-16 (Claim/service lacks information or has submission/billing error(s).): Used when admission or discharge information on the claim is missing or wrong.
  • N143 (The patient was not in a hospice program during all or part of the service dates billed.): The hospice version: the patient was not in a hospice program for all or part of the dates.
  • N147 (Long term care case mix or per diem rate cannot be determined because the patient ID number is missing, incomplete, or invalid on the assignment…): The long-term care rate cannot be set because the patient ID on the assignment request was invalid.
  • CO-239 (Claim spans eligible and ineligible periods of coverage.): The claim spans eligible and ineligible periods and must be rebilled separately.

N141 FAQ

Who typically receives N141?

Long-term care facilities billing a program such as Medicaid for resident days, and sometimes other providers whose payment depends on the patient being a resident.

What if the patient was on a hospital leave?

Leave days are handled under program-specific rules. Report them the way the payer requires, since unreported leave can make days look unmatched.

Can I rebill just the matched days?

Often yes. Correct the service dates to the documented residency and resubmit following the payer's replacement claim process.