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N213 Remark Code: Facility DRG or Exempt Status Issue

N213 means the hospital claim lacked valid information about the facility's or discrete unit's DRG, or about its DRG-exempt status. The payer needs to know whether the stay should be paid by DRG or under a different method for an exempt unit.

Quick facts

Code
N213 (RARC N213)
Status
Active In use since April 1, 2004; last modified March 14, 2014.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The claim was denied or held for a facility data problem. The hospital must correct it; the patient is not responsible.
Official description
Missing/incomplete/invalid facility/discrete unit DRG/DRG exempt status information.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N213 means

Not every inpatient bed in a hospital is paid the same way. Acute-care stays are commonly paid by DRG, while certain distinct units are exempt and paid under other methods. The payer needs to know which applies to the stay. N213 means the information identifying the facility or discrete unit’s DRG status, or its exemption, was missing or could not be validated. It usually explains CARC 16.

Common causes

  • A stay in an exempt unit was billed under the main hospital’s identifiers.
  • The unit’s provider number or payer-specific identifier was omitted.
  • The payer’s enrollment file does not show the unit as exempt for the service dates.
  • Revenue codes and type of bill were inconsistent with the unit where care was delivered.
  • The patient transferred between the acute hospital and the exempt unit, and the claims were not split correctly.

How to fix it

  1. Confirm where the patient stayed on each day and which unit is responsible for each part of the stay.
  2. Verify the unit’s identifiers and exempt status with your enrollment team and the payer.
  3. Correct the claim’s facility identifiers, type of bill, and revenue codes to match the unit, splitting the stay if required.
  4. Submit a replacement claim with the original claim number, or a new claim if the payer requires one for a different unit.
  5. If the payer’s enrollment data is wrong, update it before resubmitting.

How to prevent it

Keep a clear crosswalk between each hospital unit and its billing identifiers for each payer. Registration should record unit transfers so billing can split stays correctly, and enrollment changes to exempt units should be communicated to payers well before they take effect.

Codes that may appear with N213

  • CO-16 (Claim/service lacks information or has submission/billing error(s).): The claim lacks information needed to adjudicate; N213 names the facility or unit DRG status.
  • CO-B7 (This provider was not certified/eligible to be paid for this procedure/service on this date of service.): The facility or unit was not certified or eligible for the payment method billed on that date.
  • N208 (Missing/incomplete/invalid DRG code.): The DRG code itself was missing or invalid.
  • MA30 (Missing/incomplete/invalid type of bill.): The type of bill was missing or invalid, which can also misidentify the unit.
  • CO-232 (Institutional Transfer Amount.): Institutional transfer amount explaining DRG differences when care crosses facilities.

N213 FAQ

What is a DRG-exempt unit?

Some hospitals operate distinct units, such as inpatient psychiatric or rehabilitation units, that are paid under a different system than the main acute-care DRG system. Those units are often called exempt or distinct part units.

How does the payer know which unit provided care?

Usually through the provider identifiers, type of bill, revenue codes, and enrollment information for that unit. If any of these point to the wrong unit, N213 can result.

Does N213 apply to physician claims?

No. It is an institutional code about how the hospital or unit is paid.