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N436 Remark Code: Injury Claim Not Accepted, Interim Payment

N436 means the injury claim has not been accepted, but the carrier has made a mandatory medical reimbursement. In workers' compensation, some jurisdictions require a carrier to pay for limited medical care while it is still deciding whether the injury is compensable.

Code: N436 (RARC N436)
Status: Active In use since July 1, 2008.
Code set: Remittance Advice Remark Codes (RARC)
Group codes: CO (Contractual Obligation): The carrier paid what the jurisdiction's rules require during the pending period. Any remaining balance is typically on hold, not billable to the injured worker while compensability is undecided.
OA (Other Adjustment): Some carriers show the unpaid portion as an other adjustment until the injury claim is accepted or denied.
Official description: The injury claim has not been accepted and a mandatory medical reimbursement has been made.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What N436 means

When a worker reports an injury, the carrier usually has a period to investigate before accepting or denying the claim. Some state workers’ compensation systems require the carrier to pay for a limited amount of medical care during that period, so treatment is not delayed. N436 tells you this payment is one of those mandatory interim reimbursements, and that the injury claim itself is still not accepted.

The remark is specific to workers’ compensation and similar property and casualty settings. The details, including how much must be paid and for how long, depend on the jurisdiction.

Why the claim is only partly paid

The carrier has not decided whether the injury is work-related.
Jurisdictional rules require payment only up to a limit or for a period of time.
Remaining charges wait for the compensability decision.

What to do

Post the payment as an interim workers’ compensation payment and keep the balance open.
Track the claim status with the adjuster. Note the claim number, the date of injury, and any expected decision date.
Keep documenting the work-related nature of the injury in the medical record, including the mechanism of injury and work restrictions.
When the claim is accepted, ask the carrier to reprocess the remaining charges, and resubmit if it requires.
If the claim is denied, obtain the denial and bill the patient’s health plan or the patient according to the jurisdiction’s rules.

How to stay ahead

Collect the employer, carrier, adjuster, and claim number at the first visit, along with the patient’s health insurance as a backup. Record the state jurisdiction on the account, since rules differ widely.

Codes that may appear with N436

CO-P8 (Claim is under investigation.): The claim is under investigation, which is often why the injury claim has not been accepted yet.
CO-P13 (Payment reduced or denied based on workers' compensation jurisdictional regulations or payment policies, use only if no other code is applicable.): Payment reduced or denied under workers' compensation jurisdictional regulations or payment policies.

N437 (Alert: If the injury claim is accepted, these charges will be reconsidered.): An alert that the charges will be reconsidered if the injury claim is accepted.
N470 (This payment will complete the mandatory medical reimbursement limit.): This payment completes the mandatory medical reimbursement limit.
CO-P4 (Workers' Compensation claim adjudicated as non-compensable.): The workers' compensation claim was adjudicated as non-compensable.

N436 FAQ

Is this payment final?

Not necessarily. It is an interim payment made under jurisdictional rules. If the carrier later accepts the claim, the remaining charges are typically reconsidered.

Can I bill the injured worker's health plan?

Rules vary by state and plan. Some health plans will pay pending a compensability decision and later seek recovery; others will not. Check both the jurisdiction's rules and the health plan's policy.

Can I bill the patient for the balance?

Workers' compensation rules often restrict billing the injured worker while a claim is pending. Check the jurisdiction's rules before sending a patient statement.

Important: read before using this information

This page is general educational information about a standard industry code set. It is not medical billing, coding, legal, reimbursement, or compliance advice, and it does not create a professional or advisory relationship with ClaimsRevenue.

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