Look up another code

N674 Remark Code: Prerequisite Service Not Found

N674 means the payer covers this service only if a prerequisite procedure or service was provided first, and it could not confirm that the prerequisite happened. Proof of the earlier service, or a correction linking it, is usually needed.

Code: N674 (RARC N674)
Status: Active In use since July 15, 2013.
Code set: Remittance Advice Remark Codes (RARC)
Group codes: CO (Contractual Obligation): The service is denied because a coverage condition wasn't shown to be met. It is the provider's responsibility unless the patient agreed to pay in advance where the payer allows.
PR (Patient Responsibility): The plan may hold the patient responsible where the benefit terms make the service non-covered without the prerequisite and proper notice was given.
Official description: Not covered unless a pre-requisite procedure/service has been provided.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What N674 means

Some coverage rules are sequential. A payer might cover an advanced imaging study only after an initial test, a procedure only after a trial of conservative treatment, or a follow-on service only after a primary procedure. N674 means this claim hit one of those rules and the payer’s records didn’t show the required earlier step.

The problem may be clinical, if the step was skipped, or purely informational, if the step happened but the payer couldn’t see it.

Common causes

The prerequisite service was performed by another provider or paid by another payer, so it’s not in this payer’s history.
It was performed but not yet billed, or it was billed after this claim.
The claim didn’t reference the related service, procedure, or date when the payer requires that link.
The earlier step was documented in the chart but not in the records sent.
The step was genuinely skipped, sometimes for a clinical reason that wasn’t documented.

How to fix it

Find the payer’s policy naming the required prerequisite and any timing rules.
Locate proof that the prerequisite happened: the claim, the report, or chart notes, including its date.
Bill the prerequisite first if it hasn’t been billed, then ask the payer to reprocess this claim.
Appeal with documentation when the prerequisite was provided elsewhere, or when a clinical reason justified skipping it.
Correct the claim with resubmission code 7 if a required reference, such as additional information in box 19, was missing.

How to prevent it

For services with known prerequisites, confirm during scheduling or authorization that the earlier step is on record and document it in the order. The authorization and referral guide covers building these checks into intake.

Codes that may appear with N674

CO-107 (The related or qualifying claim/service was not identified on this claim.): The related or qualifying claim or service was not identified on this claim.
CO-272 (Coverage/program guidelines were not met.): Coverage or program guidelines were not met.
CO-50 (These are non-covered services because this is not deemed a 'medical necessity' by the payer.): Not deemed medically necessary without the prerequisite step.

N661 (Documentation does not support that the services rendered were medically necessary.): The documentation reviewed does not support medical necessity.
N703 (This service is incompatible with previously adjudicated claims or claims in process.): The service is incompatible with previously adjudicated claims or claims in process.
N702 (Decision based on review of previously adjudicated claims or for claims in process for the same/similar type of services.): A decision based on reviewing prior claims for the same or similar services.

N674 FAQ

What if the prerequisite was billed by another provider?

The payer may not have linked the two claims, especially if the earlier one went to a different payer. Send documentation of the earlier service, such as the report or record, with your appeal.

What if the prerequisite was never done?

Then the service likely doesn't meet the payer's criteria. Review whether an exception applies and document it, or accept the denial.

Does this relate to step therapy?

Step therapy is one example of a prerequisite requirement, but N674 can apply to any service the payer ties to an earlier one, such as a diagnostic test before a procedure.

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.