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N168 Remark Code (Deactivated): Patient Must Choose Option

N168 meant payment could not be made until the patient chose an option for the procedure, equipment, supply, or service. X12 deactivated it and suggested N160, which has the same wording and is active.

X12 deactivated RARCN168 on January 31, 2004. Payers should no longer use it on new remittances, but it can still appear on older ERAs, corrected claims, and appeals.

Code: N168 (RARC N168)
Status: Deactivated StoppedJanuary 31, 2004 (in use since February 28, 2003).
Code set: Remittance Advice Remark Codes (RARC)
Group codes: CO (Contractual Obligation): Paired with CO adjustments; the claim was held up until the patient's election was on file.
Official description: The patient must choose an option before a payment can be made for this procedure/ equipment/ supply/ service.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What N168 meant

Remark N168 said the payer was waiting on the patient. Some benefits require the patient to make a choice, for example between renting or buying an item, and payment depends on that decision. Until the election was made, the payer would not pay the claim.

What replaced it

X12’s note suggested N160. N160 keeps the same text and is active. At the adjustment level, CO-106 says the patient’s payment option or election is not in effect. For equipment, rent-versus-purchase issues can also appear as CO-108.

If you still see N168

It was active only briefly, so it should appear only in older remittances. For a current election-related denial, contact the patient, document their choice on the form the payer uses, and resubmit or ask the payer to reprocess.

N160 (The patient must choose an option before a payment can be made for this procedure/ equipment/ supply/ service.): The suggested replacement, with the same text.
CO-106 (Patient payment option/election not in effect.): Patient payment option or election not in effect.
CO-108 (Rent/purchase guidelines were not met.): Rent or purchase guidelines were not met.

N168 FAQ

What kinds of options does this refer to?

Examples include a patient's choice between renting and purchasing certain equipment, or another election that the payer requires before it can decide how to pay.

What should the provider do?

Help the patient make and document the election the payer requires, then resubmit the claim with the information included.

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