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N22 Remark Code: Procedure Code Added or Changed

N22 is an alert that the payer added or changed a procedure code on the claim because it believes the new code more accurately describes the services rendered. Payment was calculated on the payer's code, not the one you billed.

Code: N22 (RARC N22)
Status: Active In use since January 1, 2000; last modified July 1, 2015.
Code set: Remittance Advice Remark Codes (RARC)
Group codes: CO (Contractual Obligation): The difference between your billed code and the payer's code is typically a provider adjustment, not a patient balance.
PR (Patient Responsibility): Patient cost-sharing is calculated on the payer's replacement code.
Official description: Alert: This procedure code was added/changed because it more accurately describes the services rendered.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What N22 means

N22 tells you the procedure code on the remittance may not be the one you sent. The payer either replaced your code or added one, and it priced the service using its choice. The line usually still pays, but often at a different (commonly lower) amount.

Common pairings include CARC 150, when the payer believes the documentation supports a different level of service, and CARC 45 for the resulting pricing difference.

What to do

Compare billed and adjudicated codes. The ERA reports both when a payer changes a code, so you can see what was substituted.
Review the documentation against each code’s definition and the payer’s coding policy.
Dispute unsupported changes. File a reconsideration or appeal with the notes, explaining why your original code is correct.
Learn from supported changes. Share the finding with the coder or provider so future claims use the right code.

Tracking how often payers recode particular services is useful, because a steady pattern of downcoding can signal a documentation gap or a payer policy you need to challenge. See how to analyze CARC and RARC patterns.

Codes that may appear with N22

CO-150 (Payer deems the information submitted does not support this level of service.): The payer found the information did not support the level of service billed, and recoded it.
CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): The allowance reflects the fee schedule for the replacement code.

N56 (Procedure code billed is not correct/valid for the services billed or the date of service billed.): The billed procedure code is not correct or valid for the service or date, without the payer supplying a replacement.
N69 (Alert: PPS (Prospective Payment System) code changed by claims processing system.): Alert that a prospective payment system code was changed by the claims system.
N72 (PPS (Prospective Payment System) code changed by medical reviewers.): A prospective payment system code was changed by medical reviewers.

N22 FAQ

Can a payer change my procedure code?

Many payer contracts and policies allow recoding when the payer believes a different code fits the documentation or its coding rules. Check your agreement for the terms.

How do I dispute the change?

Compare the documentation to both code definitions. If your original code is supported, submit a reconsideration or appeal with the records and a short explanation.

Should I rebill with the new code?

No, the payer already processed it under the new code. Change your coding going forward only if you agree the payer's code is correct.

Important: read before using this information

This page is general educational information about a standard industry code set. It is not medical billing, coding, legal, reimbursement, or compliance advice, and it does not create a professional or advisory relationship with ClaimsRevenue.

Code definitions, payer usage, contracts, and laws change, and payers may apply the same code differently. The information is provided “as is,” without warranties of any kind, express or implied, including accuracy, completeness, or currency. You are solely responsible for verifying it against the current official X12 code lists, CMS guidance, your payer contracts, and payer policies before relying on it, and for every billing, coding, collection, and appeal decision you make.

Using this information does not guarantee that any claim will be paid or that any appeal will succeed. To the fullest extent permitted by law, ClaimsRevenue and MOODRX LLC are not liable for any loss or damage arising from its use. Official code descriptions are published by X12 and are quoted for reference only. See our full Claims Validation Disclaimer.