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N589 Remark Code: Impaired Driver Coverage Exclusion

N589 means the payer excluded coverage because the injured person was operating a motor vehicle while intoxicated or while impaired by drug use. The exclusion is in the policy or state law, so this payer will not pay for the resulting care.

Quick facts

Code
N589 (RARC N589)
Status
Active In use since July 15, 2013.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • OA (Other Adjustment): The carrier excludes the injury. Another payer, such as a health plan, may need to be billed.
  • PR (Patient Responsibility): Some carriers show the amount as patient responsibility; other coverage and state law determine what can be collected.
Official description
Coverage is excluded to any person injured as a result of operating a motor vehicle while in an intoxicated condition or while the ability to operate such a vehicle is impaired by the use of a drug.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N589 means

Some auto insurance policies and state laws exclude benefits for a person injured while operating a vehicle under the influence of alcohol or drugs. N589 tells you that exclusion was applied. The wording focuses on the operator: passengers and other injured people are generally not covered by this particular exclusion, though other rules may apply to them.

It commonly appears with CARC 160 (injury from an excluded activity), P21, or P6.

Why it happens

  • The insurer’s investigation, police report, or records indicate the patient was the impaired driver.
  • The policy or state law contains an intoxication exclusion for the operator’s own injuries.

What to do

  1. Confirm the exclusion with the adjuster and ask for the decision in writing.
  2. Bill the patient’s health insurance or other coverage, including the denial if requested. Be aware that health plan rules for these injuries vary and some states restrict intoxication exclusions.
  3. Let the patient know the auto carrier has denied their claim so they can dispute it if they believe the finding is wrong.
  4. Hold patient billing until other coverage has been tried, in line with state rules and your policies.

How to prevent problems

You cannot prevent the exclusion, but collecting all of the patient’s coverage at intake means a denial like this moves quickly to the next payer. See coordination of benefits denials.

Codes that may appear with N589

  • CO-160 (Injury/illness was the result of an activity that is a benefit exclusion.): The injury resulted from an activity that is a benefit exclusion.
  • CO-P21 (Payment denied based on the Medical Payments Coverage (MPC) and/or Personal Injury Protection (PIP)): Denied under PIP or medical payments jurisdictional rules.
  • CO-P6 (Based on entitlement to benefits.): Denied based on entitlement to benefits.
  • N586 (The injured party does not qualify for benefits.): The injured party does not qualify for benefits, without a stated reason.
  • N584 (Not covered based on the insured's noncompliance with policy or statutory conditions.): Not covered because of noncompliance with policy or statutory conditions.
  • N578 (Coverages do not apply to this loss.): No coverage on the policy applies to this loss.

N589 FAQ

Will the patient's health insurance pay?

It may, but some health plans have their own exclusions for injuries related to intoxication, and many states limit or prohibit such exclusions. Check the plan and state law.

What evidence does the insurer use?

Often police reports, toxicology results, or medical records. The patient may be able to dispute the finding with the insurer.

Should clinical documentation change because of this?

No. Document clinical findings accurately. Billing outcomes should not influence the medical record.