N781 remark code

Remittance advice remark code N781. Remark codes add detail to the reason code on the same claim line.

QMB or Medicaid patient: deductible

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 N781 means

An alert that the patient is Medicaid or QMB, so check for any deductible collected by mistake, which may go to the next payer.

N781 is an informational alert. The patient has Medicaid or Qualified Medicare Beneficiary status, and deductible amounts generally should not be collected from them. The remark asks you to check whether any was collected in error.

The deductible amount is usually billed to the next payer, such as the state Medicaid program. Related alerts cover coinsurance and copays.

Common causes

• Deductible remained on a claim for a dually eligible patient.
• The patient paid the deductible at the front desk.
• The secondary Medicaid coverage was not on file when the claim was billed.

What to do next

1. Check the account for any deductible amount collected from the patient.
2. Refund the patient if a deductible was collected in error, following your policy.
3. Bill the deductible to the Medicaid program or other secondary payer.
4. Flag the account so future cost sharing is not collected from the patient.

Related codes

• N192 (remark code) Patient is Medicaid or QMB
• N830 (remark code) Balance billing protections apply
• 1 (reason code) Amount applied to the deductible