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N374 Remark Code: Part A Exhausted, Part B RA Needed

N374 means the patient's primary Medicare Part A coverage has been exhausted, and the payer needs the Medicare Part B remittance advice for the services before it can process the claim.

Quick facts

Code
N374 (RARC N374)
Status
Active In use since December 1, 2006.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The claim is held or denied until the provider supplies the Part B remittance. The patient is not billed while the information is outstanding.
  • OA (Other Adjustment): Some secondary payers report this as an other adjustment because it concerns coordination with Medicare rather than a coverage decision.
Official description
Primary Medicare Part A insurance has been exhausted and a Part B Remittance Advice is required.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N374 means

When a Medicare patient’s Part A inpatient or skilled nursing benefits run out, the payment picture changes. Part A stops paying, but some services may still be billable to Medicare Part B. A secondary payer that sees Part A is exhausted will want to know what Part B did before it pays anything. N374 asks you for that Part B remittance advice.

The remark usually explains CARC 16 or CARC 22 from a secondary or supplemental payer.

Common causes

  • The facility billed the secondary payer with only the Part A remittance, which showed benefits exhausted.
  • Eligible ancillary services were never billed to Part B.
  • The Part B claim was billed but hadn’t finished processing when the secondary claim went out.
  • The Part B remittance was sent, but the COB data in the claim did not reflect it.

What to do

  1. Confirm from the Part A remittance or eligibility data that Part A benefits were exhausted for the dates in question.
  2. Bill eligible services to Medicare Part B according to Medicare’s instructions for exhausted-benefit situations, if not already done.
  3. Once Part B processes, obtain its remittance advice.
  4. Resubmit to the secondary payer with the Part B payment and adjustment data, either electronically in the COB fields or with the remittance attached as the payer requires.
  5. For services Part B doesn’t cover, include the Part B denial so the secondary payer can decide its liability.

How to prevent it

Monitor benefit days for long stays and flag patients approaching exhaustion. Build a workflow that routes eligible services to Part B once Part A ends, and hold secondary claims until the Part B remittance has posted.

Codes that may appear with N374

  • CO-16 (Claim/service lacks information or has submission/billing error(s).): The claim lacks information needed for processing; N374 names the Part B remittance.
  • OA-22 (This care may be covered by another payer per coordination of benefits.): Another payer (Medicare Part B) may be responsible under coordination of benefits.
  • M28 (This does not qualify for payment under Part B when Part A coverage is exhausted or not otherwise available.): Says a service does not qualify for Part B payment when Part A coverage is exhausted or unavailable.
  • 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 payment information.
  • N4 (Missing/Incomplete/Invalid prior Insurance Carrier(s)): Used when the prior insurance carrier's EOB is missing or invalid.

N374 FAQ

What does it mean that Part A is exhausted?

The patient has used the Part A benefit days available for the stay, so Part A no longer pays. Certain services may then be billable to Part B.

Which services can go to Part B?

Medicare allows some ancillary services to be billed under Part B when Part A benefits are exhausted or not available. Follow Medicare's instructions for which services and which bill type qualify.

Who uses N374?

Mostly secondary or supplemental payers, such as Medicaid or Medicare supplement plans, that must coordinate after Medicare.