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N424 Remark Code: Patient Outside Required Geographic Area

N424 means the patient does not reside in the geographic area required for this type of payment. The payer's records place the patient's residence outside a service area, county, state, or region that the program or benefit is limited to.

Quick facts

Code
N424 (RARC N424)
Status
Active In use since August 1, 2007.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): Often used when the payment type depends on a provider or program arrangement tied to an area. The provider generally cannot bill the patient without a valid basis.
  • PR (Patient Responsibility): If the patient's plan does not cover care for members outside its area, the payer may assign the amount to the patient.
Official description
Patient does not reside in the geographic area required for this type of payment.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N424 means

Some payments depend on where the patient lives. A county-based managed care plan, a state-funded program, or a payment method designed for particular regions may only pay when the patient resides inside a defined area. N424 says the payer checked the patient’s residence and found it outside the required area for this kind of payment.

Look for N424 with CARC 180 (residency requirements not met) or CARC 177 (eligibility requirements not met).

Common causes

  • The patient moved out of the plan’s service area, and the plan has not yet transitioned their coverage.
  • Out-of-date enrollment address. The patient moved into the area, but the payer still lists the old address.
  • Claim address error. Registration keyed the wrong ZIP code, city, or state on the patient demographics.
  • Wrong plan billed. The patient belongs to a different regional plan from the same carrier.
  • Temporary residence. The patient is staying elsewhere (for school, seasonal work, or caregiving) but is enrolled based on a home address.

How to fix it

  1. Confirm the patient’s current address directly with the patient and compare it with the address on the claim (CMS-1500 box 5 for the patient’s address).
  2. Run an eligibility check to see what address and plan the payer has on file.
  3. If your claim was wrong, fix the demographics and send a corrected claim with resubmission code 7.
  4. If the payer’s record is wrong, ask the patient to update their address with the plan or program, then request reprocessing.
  5. If the patient is actually out of area, find the plan or program that covers them where they live, or check whether the plan covers out-of-area care under emergency or travel provisions.

How to prevent it

Verify addresses at every visit, not just the first, and re-check eligibility when a patient mentions a move. For regional plans, confirm that the patient’s ZIP code falls inside the plan’s service area as part of registration. Broader eligibility pitfalls are covered in eligibility and COB denials.

Codes that may appear with N424

  • CO-180 (Patient has not met the required residency requirements.): The patient has not met the required residency requirements.
  • CO-177 (Patient has not met the required eligibility requirements.): The patient has not met the required eligibility requirements, with N424 naming geography as the problem.
  • CO-109 (Claim/service not covered by this payer/contractor.): The claim should go to a different payer, for example the plan serving the patient's actual area.
  • N30 (Patient ineligible for this service.): A broader statement that the patient is ineligible for this service.
  • N216 (We do not offer coverage for this type of service or the patient is not enrolled in this portion of our benefit package.): The patient is not enrolled in the portion of the benefit package that covers the service.
  • CO-31 (Patient cannot be identified as our insured.): Used when the payer cannot identify the patient as its insured at all.

N424 FAQ

What kinds of payments are limited by geography?

Examples include regional or county-based managed care plans, state programs that serve residents only, and payment methods tied to rural or designated areas. The specific rule comes from the payer or program.

The patient moved recently. Does that matter?

Yes. If the patient moved out of the plan's area, the plan may have ended or changed coverage. If they moved in and the payer has an old address, updating it with the payer may resolve the denial.

Should I just change the address on the claim?

Only if the address you billed was wrong. The payer usually checks its own enrollment records, so the patient may also need to update their address with the plan.