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N163 Remark Code: Record Doesn't Support Code Billed

N163 means the medical record does not support the code billed according to that code's definition. After reviewing documentation, the payer concluded that what was recorded does not meet the requirements the code describes.

Quick facts

Code
N163 (RARC N163)
Status
Active In use since February 28, 2003.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): A documentation-based denial or reduction the provider absorbs; the patient cannot be billed for the unsupported portion.
Official description
Medical record does not support code billed per the code definition.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N163 means

Every procedure code has a definition: components that must be performed, time thresholds, or elements that must be documented. N163 tells you a reviewer compared your record with that definition and found a gap. The result may be a denial, or a reduction to a code that the record does support.

It typically follows a records request or review and pairs with CARC 150 or CARC B12.

Common causes

  • Time-based services were billed without start and stop times or total time.
  • The note lacks elements required for the level billed.
  • A procedure note describes a less extensive procedure than the code billed.
  • Required signatures, orders, or interpretations are missing.
  • Templated notes do not reflect what was actually done.

What to do

  1. Get the code definition and any payer guidance for it.
  2. Compare it line by line with the record the payer reviewed.
  3. If the record supports the code, appeal with a cover letter pointing to each required element in the notes.
  4. If it supports a different code, follow the payer’s instructions for correcting the claim.
  5. If it supports neither, accept the decision and use it for education.

How to prevent it

Audit documentation for your highest-volume and highest-value codes, and give clinicians specific feedback on missing elements. Pre-bill coding review for services that payers frequently review can catch gaps before submission.

Codes that may appear with N163

  • CO-150 (Payer deems the information submitted does not support this level of service.): The information does not support this level of service.
  • CO-B12 (Services not documented in patient's medical records.): Services not documented in the patient's medical records.
  • CO-50 (These are non-covered services because this is not deemed a 'medical necessity' by the payer.): The service billed was not deemed medically necessary based on the records reviewed.
  • M25 (The information furnished does not substantiate the need for this level of service.): The information furnished does not substantiate the need for this level of service.
  • N10 (Adjustment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review.): An adjustment based on a review organization or medical advisor findings.
  • N109 (Alert: This claim/service was chosen for complex review.): The claim was chosen for complex review, which often precedes N163.

N163 FAQ

Is N163 about medical necessity?

Not primarily. It is about documentation matching the code definition, such as required components, time, or elements. A service can be necessary and still be coded at a level the record does not support.

Can I resubmit with a lower code?

If the record supports a different code, a corrected claim with that code may be appropriate. Follow the payer's process, since some require an appeal instead after a review.

Can I add documentation later?

Late entries must follow proper amendment rules and are viewed skeptically. Appeals should rely on documentation created at the time of service.