Which of the following is an example of a remark code from an explanation of benefits document?

• A. Contractual allowance
• B. Payment in full
• C. Deductible not met
• D. Copayment

Answer: (A)

Remark codes on an Explanation of Benefits explain why a charge was adjusted or how it was processed. A contractual allowance is the classic example of a remark code because it specifically notes the reduction in the billed amount due to the payer’s contracted rate with the provider. It isn’t saying the payment was made in full, nor is it indicating that a deductible hasn’t been met or that a copayment is due. Those items describe amounts due or paid, not the coded adjustment explaining the discount from the contract. So the contractual allowance best fits as a remark code.