N381 remark code

Remittance advice remark code N381. Remark codes add detail to the reason code on the same claim line.

Check your contract terms

Unofficial reference. This is our own plain-English explanation, not the official code text. Payer rules differ. Verify with the payer and the official X12 code list. AlphaPrefix is not affiliated with X12, CMS or any payer. Data last updated Nov 11, 2026.

What N381 means

An alert pointing you to your contract with the payer for restrictions or billing and payment rules on these charges.

N381 is an informational alert. The payer applied a term in your provider agreement, such as a payment rule, a carve-out, a billing restriction or a contracted rate, and wants you to look there for the details.

It sits alongside the reason code that explains the actual adjustment, often 45 or 97.

Common causes

• A contract provision limits payment for these charges or how they may be billed.
• The service is carved out of or bundled into a contracted rate.
• The payer applied a contracted payment method, such as a case rate or per diem.

What to do next

1. Read the reason code and group code first to see the type of adjustment.
2. Find the matching term in your contract or its fee schedule exhibits.
3. Dispute through the payer's provider dispute process if the contract was misapplied.
4. Share the finding with the contracting team if the term is causing repeat losses.

Related codes

• 45 (reason code) Charge exceeds the allowed amount
• 97 (reason code) Service included in another payment
• N130 (remark code) Check plan benefits for restrictions