Look up another code

N690 Remark Code: Reversal After Provider Appeal

N690 is an alert that the payer reversed its original processing of the claim because of an appeal the provider submitted. The claim is then reprocessed according to the appeal decision, which is often, but not always, a higher payment.

Code: N690 (RARC N690)
Status: Active In use since November 1, 2013; last modified March 14, 2014.
Code set: Remittance Advice Remark Codes (RARC)
Group codes: CO (Contractual Obligation): The original payment and adjustments are reversed. The reprocessed claim shows the new contractual adjustments that reflect the appeal outcome.
PR (Patient Responsibility): Patient cost-sharing may be recalculated on the reprocessed claim and reported under PR.
Official description: Alert: This reversal is due to a provider submitted appeal.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What N690 means

This one is usually good news. You appealed a denial or underpayment, the payer reconsidered, and to put its new decision into effect it reversed the original claim processing. N690 marks that reversal. A reprocessed version of the claim normally appears on the same or a later remittance.

Because the reversal and the reprocessed claim are separate entries, it’s easy to post only half of the transaction. Look for both.

What to do

Find the reprocessed claim that follows the reversal and post both together.
Compare the result to the appeal decision letter. The payment should match what the payer agreed to.
Update patient balances if cost-sharing changed, and refund any overpayment.
Close the appeal in your tracking system, recording the outcome and the amount recovered.
Escalate if the reprocessing doesn’t reflect the decision, or move to the next appeal level if the decision itself was unfavorable.

Tracking appeal outcomes by payer and reason shows which denials are worth appealing and which are better prevented. For a framework, see how to analyze CARC and RARC patterns.

Codes that may appear with N690

CO-64Deactivated (Denial reversed per Medical Review.): Denial reversed per medical review, sometimes seen with appeal outcomes.

N691 (Alert: This reversal is due to a patient submitted appeal.): The same kind of reversal, but triggered by the patient's appeal.
MA91 (Alert: This determination is the result of the appeal you filed.): Alert that the determination is the result of the appeal you filed.
N688 (Alert: This reversal is due to a medical or utilization review decision.): A reversal driven by a medical or utilization review, not by an appeal.

N690 FAQ

Why does a successful appeal show up as a reversal?

Payers often correct a claim by backing out the original processing and reprocessing it in full. The reversal and the new claim together show the net change.

What if the reprocessed payment is still wrong?

Check the appeal decision letter. If the payer didn't reprocess as the decision says, contact it; if you disagree with the decision, the letter should describe the next appeal level.

Do I need to rebill the patient?

Only if the patient's responsibility changed. Compare the new PR amounts to what the patient was billed or paid.

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.