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N412 Remark Code: Allowed Twice in a 12-Month Period

N412 means the service is allowed two times in a 12-month period. The payer found two earlier services within the preceding 12 months, so this one exceeded the limit and was denied or reduced.

Quick facts

Code
N412 (RARC N412)
Status
Active In use since August 1, 2007; last modified July 1, 2016.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): Where the limit is a payer policy or contract term, the extra service is a provider write-off.
  • PR (Patient Responsibility): Where the limit is the patient's benefit, the patient may be responsible, subject to advance notice and contract rules.
Official description
This service is allowed 2 times in a 12-month period.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N412 means

With N412, the payer is applying a rolling limit: two services in any 12-month span. When a new claim arrives, the payer looks back 12 months from its date of service and counts how many of the same service it already allowed. If that count is already two, the new line is denied or reduced.

This remark typically supports CARC 119 (benefit maximum for the period) or CARC 151 (frequency not supported).

Why it is easy to miss

Rolling windows do not line up with the calendar. A patient seen in March and September may assume the new year means a fresh start, but a February visit the following year still sits inside the 12 months that include both earlier services. Other contributors:

  • Services at a different practice that count against the same limit.
  • An earlier claim billed with the wrong date of service, which shifts the window.
  • A service billed twice by mistake, so the payer’s count is inflated. See duplicate claim denials.

What to do

  1. Get the dates the payer counted. Your remittance or a call to provider services should show the two prior services.
  2. Check each prior date against your records. If one was billed in error or with the wrong date, correct that claim first.
  3. Recalculate the window. If the current date of service actually falls outside the 12-month look-back, ask the payer to reprocess.
  4. Request an exception or appeal when the extra service was clinically needed, with documentation.
  5. Otherwise, treat it as a valid limit and bill according to your contract and any notice you gave the patient.

How to prevent it

Before scheduling, count how many of the service the patient has had in the last 12 months, not the current calendar year. Eligibility and benefit responses sometimes show remaining frequency, so check them where available.

Codes that may appear with N412

  • PR-119 (Benefit maximum for this time period or occurrence has been reached.): The benefit maximum for the period has been reached; N412 defines it as two per 12 months.
  • CO-151 (Payment adjusted because the payer deems the information submitted does not support this many/frequency of services.): The payer does not consider this frequency of service supported.
  • N413 (This service is allowed 2 times in a benefit year.): Also two services, but counted per benefit year instead of a rolling 12 months.
  • N414 (This service is allowed 4 times in a 12-month period.): A higher limit of four services per 12-month period.
  • N640 (Exceeds number/frequency approved/allowed within time period.): A general notice that the approved or allowed number or frequency within a time period was exceeded.

N412 FAQ

What is a rolling 12-month period?

It looks back 12 months from the date of the service being billed. The count does not reset on January 1 or on the plan renewal date, which is what separates N412 from a benefit-year limit.

Why did the first two services pay and the third deny?

That is how the limit works. The payer counts earlier paid services in the look-back period. Once two have been allowed, any third service inside that 12-month span is over the limit.

Does a denied earlier service count toward the two?

Usually only allowed services count, but payer practice varies. If a prior service was denied or reversed, ask the payer whether it is included in its count.