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N183 Remark Code: Predetermination Advisory

N183 is an alert on a predetermination response. It tells you that when the service is later submitted for payment, the plan will require additional documentation, as described in its plan documents, before it can process benefits.

Quick facts

Code
N183 (RARC N183)
Status
Active In use since February 28, 2003; last modified April 1, 2007.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • OA (Other Adjustment): Predetermination responses often carry OA adjustments because no payment decision has been made yet.
  • CO (Contractual Obligation): If the claim is later submitted without the documentation, a CO denial may follow; N183 is the early warning.
Official description
Alert: This is a predetermination advisory message, when this service is submitted for payment additional documentation as specified in plan documents will be required to process benefits.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N183 means

A predetermination, sometimes called a pre-treatment estimate, lets a provider ask what a plan will likely pay before delivering a service. N183 appears on that response as an advisory. The plan is saying that when you send the real claim, you should include the additional documentation its plan documents call for, or benefits will not be processed.

This remark is common in dental and some medical plans that offer predeterminations. Because it is an alert, nothing is being paid or denied yet.

What to do

  1. Note which service triggered the advisory and look up the plan’s documentation requirements for it.
  2. Make sure the clinical record will contain what the plan wants, such as radiographs, charting, notes, or a treatment plan.
  3. When you submit the payment claim, attach the documentation using the payer’s attachment method and reference the predetermination number if the payer assigns one.
  4. Remind patients that the estimate does not guarantee payment; final benefits depend on eligibility and the documentation at claim time.

If the claim later comes back with a documentation-related denial, the N183 advisory is useful evidence of what was expected. See how CARC and RARC codes work together for reading the full remittance.

Codes that may appear with N183

  • CO-252 (An attachment/other documentation is required to adjudicate this claim/service.): Documentation is required to adjudicate; N183 warns in advance that it will be needed.
  • CO-16 (Claim/service lacks information or has submission/billing error(s).): May appear when the actual claim is submitted without the documentation flagged at predetermination.
  • N133 (Alert: Services for predetermination and services requesting payment are being processed separately.): Alert that predetermination services and services requesting payment are being processed separately.
  • N360 (Alert: Coordination of benefits has not been calculated when estimating benefits for this pre-determination.): Alert that coordination of benefits was not calculated when estimating predetermination benefits.
  • N915 (Predetermination of services is not allowed under the member's plan.): Predetermination of services is not allowed under the member's plan.

N183 FAQ

Is N183 a denial?

No. It comes with a predetermination, which is an estimate, and warns that documentation will be needed at the payment stage.

What documentation will be required?

The remark refers to the plan documents. Common examples are clinical notes, images, or treatment plans, but check the plan's requirements for the specific service.

Does a predetermination guarantee payment?

No. A predetermination does not guarantee payment. Eligibility, benefits, and documentation are still reviewed when the claim is submitted.