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N806 Remark Code: Included in Global Transplant Allowance

N806 means the payer did not pay the service separately because it falls within a global allowance for the transplant episode. The single transplant payment is meant to cover this service along with the others included in the arrangement.

Code: N806 (RARC N806)
Status: Active In use since July 1, 2018.
Code set: Remittance Advice Remark Codes (RARC)
Group codes: CO (Contractual Obligation): The service is bundled into the transplant payment under the contract. It is a provider write-off, not billable to the patient.
Official description: Payment is included in the Global transplant allowance.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What N806 means

Many payers and transplant centers agree on a single payment, often called a global or case rate, that covers a transplant episode instead of paying each service separately. N806 appears on a line the payer considers part of that package. It is essentially a bundling explanation, and it usually comes with CARC 97.

Which services belong in the global allowance is set by the payer’s transplant contract or program terms, not by a universal rule. That is where the fix begins.

Common causes

Separately billed service inside the episode. Labs, imaging, or professional services during the transplant window were billed on their own.
Dates inside the global period. Follow-up care fell within the post-transplant window the contract includes.
Outside providers not aware of the arrangement. A consulting physician or independent lab billed the payer directly for included services.
Contract terms misread about which phases, such as evaluation or organ acquisition, are included.

How to fix it

Pull the transplant agreement and find the definition of the global episode: start and end dates, phases, and included services.
Compare the denied line with those terms, including its date of service.
If the service is included, post the adjustment. If you are an outside provider, pursue payment through the transplant center under your agreement, not from the patient.
If the service falls outside the global terms, contact the payer with the contract language and request reprocessing, or file an appeal.

How to prevent it

Flag transplant patients in your system with the global period dates so staff hold separately billable charges for review.
Share the included-services list with physicians and labs who treat transplant patients.
See NCCI and bundling denials for general bundling principles, keeping in mind transplant globals follow contract terms.

Codes that may appear with N806

CO-97 (The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.): The benefit is included in the payment for another service already adjudicated, here the transplant global.
OA-24 (Charges are covered under a capitation agreement/managed care plan.): Charges are covered under a managed care or capitated arrangement, which some transplant case rates are.

N167 (Charges exceed the post-transplant coverage limit.): Charges exceeded the post-transplant coverage limit.
MA126 (Pancreas transplant not covered unless kidney transplant performed.): A coverage rule about pancreas transplant tied to a kidney transplant.
CO-234 (This procedure is not paid separately.): A general notice that a procedure is not paid separately.

N806 FAQ

What does a global transplant allowance usually include?

It depends on the payer contract or transplant program agreement. Many define a transplant episode with set phases, such as evaluation, organ acquisition, the transplant stay, and a period of follow-up care. Your agreement lists what's in and out.

Can a physician outside the transplant center be affected?

Yes. If the arrangement includes professional services, claims from other providers for included services may be denied with N806 and need to be settled with the transplant center under their agreement.

How do I dispute N806?

Show that the service falls outside the global period or outside the list of included services, using the contract terms and the dates involved. Then request reprocessing or appeal.

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