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N383 Remark Code: Not Covered When Deemed Cosmetic

N383 means the service was not covered because the payer considers it cosmetic, performed mainly to change appearance rather than to treat illness, injury, or a functional problem.

Quick facts

Code
N383 (RARC N383)
Status
Active In use since April 1, 2007; last modified March 8, 2011.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • PR (Patient Responsibility): Cosmetic exclusions are commonly the patient's responsibility, especially when the patient was told in advance and agreed to pay.
  • CO (Contractual Obligation): If your contract requires advance notice before billing the patient for non-covered services and none was given, the amount may stay with the provider.
Official description
Not covered when deemed cosmetic.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N383 means

Most health plans exclude cosmetic services. N383 tells you the payer put this service in that category. The payer decided the main purpose was to improve appearance, not to treat a medical condition or restore function.

The remark is typically paired with CARC 96 or CARC 204. Some payers use CARC 50 instead.

Common causes

  • The procedure is often cosmetic, and the claim didn’t show why this case was different.
  • The diagnosis codes described appearance rather than a functional problem, symptom, or underlying condition.
  • Documentation of functional impairment (such as visual field loss, breathing difficulty, or pain) wasn’t sent or didn’t meet the payer’s policy criteria.
  • Prior authorization wasn’t obtained for a service the payer reviews for cosmetic intent.
  • The service really was cosmetic, and the patient wasn’t told it wouldn’t be covered.

What to do

  1. Read the payer’s medical policy for the procedure to see what makes it reconstructive or medically necessary.
  2. Check the diagnosis coding. Make sure the codes in box 21 reflect the underlying condition and symptoms documented.
  3. Appeal with evidence if criteria were met: clinical notes, test results, photographs, and a letter from the treating provider.
  4. Bill the patient if the service was cosmetic and the patient agreed in advance to pay, following your contract.
  5. Write off the amount if the contract bars billing the patient without advance notice that wasn’t obtained.

Our guide to authorization and referral denials covers pre-service reviews that can prevent this.

How to prevent it

For procedures that could be seen as cosmetic, check the payer’s policy and seek authorization before scheduling. Document functional effects clearly, and give patients a written financial agreement for anything that may be excluded.

Codes that may appear with N383

  • CO-96 (Non-covered charge(s).): Non-covered charges, the usual reason code for a cosmetic exclusion.
  • PR-204 (This service/equipment/drug is not covered under the patient's current benefit plan): The service is not covered under the patient's current benefit plan.
  • CO-50 (These are non-covered services because this is not deemed a 'medical necessity' by the payer.): Not deemed medically necessary, used by some payers for the same finding.
  • N356 (Not covered when performed with, or subsequent to, a non-covered service.): Denies services performed with or after a non-covered service, such as care related to a cosmetic procedure.
  • N425 (Statutorily excluded service(s).): Used for statutorily excluded services.
  • N429 (Not covered when considered routine.): Used when a service is not covered because it is considered routine.

N383 FAQ

How do payers decide a service is cosmetic?

They look at the diagnosis, documentation, and their medical policy. Services that restore function, correct a deformity from injury or disease, or relieve symptoms are more likely to be treated as reconstructive.

Can I appeal a cosmetic denial?

Yes, if the service was medically necessary. Include records showing functional impairment, symptoms, prior treatment, and photographs if the policy calls for them.

Should I get prior authorization?

For services that could be viewed as cosmetic, many payers require or recommend authorization. It is the best way to learn the payer's position before treatment.