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N86 Remark Code: Pelvic Exercise Trial Required First

N86 means biofeedback training for urinary incontinence is covered only after a failed trial of pelvic muscle exercise (PME) training. The payer did not find that failed trial documented, so it did not cover the biofeedback.

Quick facts

Code
N86 (RARC N86)
Status
Active In use since January 1, 2000.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The denial is the provider's responsibility when coverage criteria were not documented. Billing the patient usually requires advance notice, depending on the payer.
  • PR (Patient Responsibility): If the patient was notified in advance and agreed to pay, the payer may assign the service to the patient.
Official description
A failed trial of pelvic muscle exercise training is required in order for biofeedback training for the treatment of urinary incontinence to be covered.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N86 means

Medicare’s coverage policy for biofeedback in urinary incontinence, and many payer policies modeled on it, treat pelvic muscle exercise training as the first step. Biofeedback is covered for patients who tried PME and did not improve enough. N86 says the payer did not see evidence of that prior failed trial.

N86 usually accompanies CARC 50 or CARC 272, and sometimes a diagnosis-related code such as CARC 167.

Common causes

  • The chart did not document a PME trial before biofeedback started.
  • A trial was documented, but it did not meet the payer’s required length or structure.
  • The trial was done by another provider and those records were not available.
  • Biofeedback began on the same visit the PME program was introduced.

How to fix it

  1. Review the record for a documented PME trial, its dates, and the outcome.
  2. Gather outside records if another clinician supervised the trial.
  3. Appeal with documentation that shows the trial met the payer’s criteria and did not succeed.
  4. Write off or bill correctly if the criteria were not met, following the payer’s advance notice rules before billing the patient.

How to prevent it

Build the payer’s criteria into your intake for incontinence biofeedback: confirm a completed PME trial, document dates and results, and include those notes in the chart before the first biofeedback session. For Medicare patients who do not meet criteria, provide an advance beneficiary notice when appropriate.

Codes that may appear with N86

  • CO-50 (These are non-covered services because this is not deemed a 'medical necessity' by the payer.): The service was not deemed medically necessary because coverage criteria were not met.
  • CO-272 (Coverage/program guidelines were not met.): Coverage guidelines, here the prior PME trial, were not met.
  • CO-167 (This (these) diagnosis(es) is (are) not covered.): The diagnosis reported is not covered for the service under the payer's policy.
  • N87 (Home use of biofeedback therapy is not covered.): Home use of biofeedback therapy is not covered.
  • N96 (Patient must be refractory to conventional therapy (documented behavioral, pharmacologic and/or surgical corrective therapy) and be an appropriate…): The patient must be refractory to conventional therapy, a related criterion for incontinence treatments.
  • N115 (This decision was based on a Local Coverage Determination (LCD).): The decision was based on a Local Coverage Determination.

N86 FAQ

What counts as a failed PME trial?

Payer policies define it, usually as a documented course of pelvic muscle exercise training over a set period without adequate improvement. Check Medicare's national coverage policy or the payer's own policy for the exact criteria.

Where must the failed trial be documented?

In the medical record, typically by the ordering or treating clinician, including dates, the exercise program, and the outcome. Sending those notes with an appeal can overturn the denial.

Does N86 apply to other uses of biofeedback?

No. It refers to biofeedback for urinary incontinence. Other indications have their own coverage rules.