Look up another code

N513 Remark Code: Real-Time Claim Remit, Changed

N513 is an alert that this is the initial remittance for a non-NCPDP (non-pharmacy) claim originally submitted in real time, and the adjudication changed after the real-time response. Payment or patient responsibility may differ from what you saw at the point of service.

Code: N513 (RARC N513)
Status: Active In use since November 1, 2008.
Code set: Remittance Advice Remark Codes (RARC)
Group codes: OA (Other Adjustment): Informational. The alert explains that this remittance supersedes the earlier real-time result.
PR (Patient Responsibility): Patient responsibility may be different from the amount shown in real time and collected at the visit.
Official description: Alert: This is the initial remit of a non-NCPDP claim originally submitted real-time with a change to the adjudication.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What N513 means

N513 is the counterpart to N512. Both mark the first formal remittance for a medical claim that was already adjudicated in real time. With N513, the payer is telling you the result changed between the instant response and this remit. The remittance is now the controlling record.

What to do

Compare line by line with the real-time response: allowed amount, payment, and each patient cost-sharing amount.
Post from the remittance, replacing the expected amounts recorded from the real-time response.
Settle the patient account. Bill any added responsibility or refund an overpayment.
Question the change with the payer if the adjustment codes do not explain it or it conflicts with your contract.

An ERA Analyzer review of N513 remits over time shows whether real-time results from a payer are reliable enough to collect against at the visit.

Codes that may appear with N513

PR-1 / PR-2 / PR-3 (Deductible, coinsurance, and co-payment.): Updated patient cost-sharing after the change.
CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): Contractual adjustment that may have changed along with the allowed amount.

N512 (Alert: This is the initial remit of a non-NCPDP claim originally submitted real-time without change to the adjudication.): The initial remit for a real-time claim when nothing changed.
N508 (Alert: This real-time claim adjudication response represents the member responsibility to the provider for services reported.): Appears on the original real-time response describing member responsibility.
N506 (Alert: This is an estimate of the member's liability based on the information available at the time the estimate was processed.): An estimate disclaimer, used when the real-time result was only an estimate.

N513 FAQ

Why would a real-time adjudication change?

Payers do not always explain. Possible reasons include later review, other claims affecting the deductible, eligibility updates, or pricing corrections. Check the adjustment codes on the remittance.

What if I already collected from the patient?

Compare what you collected to the new patient responsibility. Bill any additional amount or refund any overpayment according to your policy and applicable rules.

Can I dispute the change?

Yes. If the new adjudication looks wrong, contact the payer or use its reconsideration process as you would for any claim.

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.

Code definitions, payer usage, contracts, and laws change, and payers may apply the same code differently. The information is provided “as is,” without warranties of any kind, express or implied, including accuracy, completeness, or currency. You are solely responsible for verifying it against the current official X12 code lists, CMS guidance, your payer contracts, and payer policies before relying on it, and for every billing, coding, collection, and appeal decision you make.

Using this information does not guarantee that any claim will be paid or that any appeal will succeed. To the fullest extent permitted by law, ClaimsRevenue and MOODRX LLC are not liable for any loss or damage arising from its use. Official code descriptions are published by X12 and are quoted for reference only. See our full Claims Validation Disclaimer.