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N658 Remark Code: Not a Medical Expense

N658 means the payer does not consider the billed service or item a medical expense, so it falls outside what the coverage pays for. Typical examples are non-medical items, convenience services, or administrative charges.

Quick facts

Code
N658 (RARC N658)
Status
Active In use since July 15, 2013.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The payer treats the charge as not billable to it and holds the provider responsible. Whether the patient can be billed depends on the plan, any advance agreement, and state rules.
  • PR (Patient Responsibility): The payer indicates the patient may be responsible for the non-medical item. Confirm the patient agreed to the charge before billing.
Official description
The billed service(s) are not considered medical expenses.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N658 means

Most coverage pays for medical expenses: services and items used to diagnose or treat an illness or injury. N658 tells you the payer placed your charge outside that definition. The issue isn’t a missing document or a coding error. The payer is saying the charge is not the type of expense it pays for at all.

The remark appears on group health, workers’ compensation, and auto claims alike. On injury claims especially, providers and vendors bill for items near the edge of “medical,” which is where N658 is most often used.

Common causes

  • Items that are mainly for comfort or daily living rather than treatment.
  • Administrative charges such as form completion, record copying, or missed-appointment fees.
  • Services from a non-clinical vendor, such as fitness, transportation, or household help, submitted as medical.
  • A legitimate medical item described in a way that made it look non-medical, such as a generic supply code without an order or diagnosis linking it to the condition.

What to do

  1. Identify the charge the payer rejected and why it might be seen as non-medical.
  2. Check the plan or jurisdiction rules for what counts as a medical expense for that item.
  3. Appeal with support if the item had a medical purpose: a prescription or order, a letter of medical necessity, and the diagnosis in box 21 pointed to in box 24E.
  4. Correct the coding if the item was described wrongly, and send a corrected claim with resubmission code 7.
  5. Bill the patient only if the group code, plan, and any signed agreement allow it.

How to prevent it

For non-routine items, get the payer’s position before providing them and document the medical reason in the order. Tell patients up front when a charge is likely to be their own cost, and get their written agreement where the payer requires it.

Codes that may appear with N658

  • CO-96 (Non-covered charge(s).): Non-covered charge, with N658 giving the reason.
  • CO-202 (Non-covered personal comfort or convenience services.): Non-covered personal comfort or convenience services.
  • PR-204 (This service/equipment/drug is not covered under the patient's current benefit plan): The service is not covered under the patient's current benefit plan, a coverage decision rather than a definition issue.
  • N643 (The services billed are considered Not Covered or Non-Covered (NC) in the applicable state fee schedule.): The service is listed as not covered in the applicable state fee schedule.
  • N621 (Charges for Jurisdiction required forms, reports, or chart notes are not payable.): Jurisdiction-required forms, reports, or chart notes are not payable.

N658 FAQ

What kinds of charges get N658?

Examples can include household or personal items, fitness or recreational services, travel and lodging, copying or form fees, and similar non-clinical charges. Each payer or jurisdiction draws the line differently.

Can I appeal N658?

Yes, if the item served a clear medical purpose. Include a physician's order or letter explaining why it was medically needed for the patient's condition.

Is N658 used on injury claims?

It can be. Workers' compensation and auto carriers often receive bills for items like home modifications or mileage, and they may use N658 when a charge isn't a medical expense under their rules.