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N360 Remark Code: COB Not Included in Estimate

N360 is an alert on a predetermination. The benefit estimate did not factor in coordination of benefits with another payer. When you bill the service, send the primary payer's payment information with the secondary claim.

Quick facts

Code
N360 (RARC N360)
Status
Active In use since November 18, 2005; last modified April 1, 2007.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): Any amount on the estimate is a contractual projection only. Actual payment will be recalculated with the other payer's information when the claim is filed.
Official description
Alert: Coordination of benefits has not been calculated when estimating benefits for this pre-determination. Submit payment information from the primary payer with the secondary claim.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N360 means

A predetermination tells you roughly what a plan would pay for proposed treatment. When a patient has more than one plan, the real payment depends on what the other plan pays first. N360 is the payer saying it did not attempt that math. The estimate reflects this plan’s benefits alone, so treat it as an upper-bound guide, not a secondary payment figure.

N360 usually appears alongside CARC 101, and sometimes CARC 22 if the payer believes another plan is primary.

What to do

  • No correction is needed on the predetermination.
  • Confirm the order of benefits with both plans before treatment, especially for dependents covered by two parents.
  • Explain to the patient that the estimate may drop once the other plan’s payment is applied.
  • Bill the primary first. After it pays, submit the secondary claim with the primary payer’s paid amount and adjustments. See eligibility and COB denials for how to build a clean secondary claim.

Keeping the predetermination on file with the COB details lets your team send a complete secondary claim the first time.

Codes that may appear with N360

  • CO-101 (Predetermination: anticipated payment upon completion of services or claim adjudication.): Predetermination: anticipated payment upon completion of services, the usual partner for estimate alerts.
  • OA-22 (This care may be covered by another payer per coordination of benefits.): Another payer may be responsible under coordination of benefits.
  • N353 (Alert: Benefits have been estimated, when the actual services have been rendered, additional payment will be considered based on the submitted claim.): A general alert that benefits have been estimated and final payment awaits the actual claim.
  • MA04 (Secondary payment cannot be considered without the identity of or payment information from the primary payer.): Secondary payment cannot be considered without the primary payer's identity or payment information.
  • N4 (Missing/Incomplete/Invalid prior Insurance Carrier(s)): Used when the prior carrier's EOB is missing or invalid on a secondary claim.

N360 FAQ

Does N360 mean this payer is secondary?

It means another coverage may affect payment and was not included in the estimate. Confirm the order of benefits before treatment.

What should the secondary claim include?

The primary payer's paid amount and adjustments, either as COB data on the electronic claim or an attached EOB, depending on the payer.

Will this payer pay the amount shown on the estimate?

Not necessarily. The estimate ignores what the other plan pays, so the actual secondary payment is often lower.