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MA48 Remark Code: Missing Primary Payer or Guarantor Info

MA48 means the claim has a missing, incomplete, or invalid name or address for the responsible party or the primary payer. The payer needs these details to coordinate benefits or to know who else is responsible for the bill.

Quick facts

Code
MA48 (RARC MA48)
Status
Active In use since January 1, 1997; last modified February 28, 2003.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The provider must supply the missing details. The patient is not billed because of a claim data error.
  • OA (Other Adjustment): Some payers report this as a coordination-of-benefits adjustment pending the primary payer information.
Official description
Missing/incomplete/invalid name or address of responsible party or primary payer.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What MA48 means

MA48 is about the other parties on a claim. When a patient has another payer ahead of the one being billed, or when a different person is financially responsible, the claim must name them and give a valid address. MA48 means one of those names or addresses was missing or unusable.

It differs from MA04, which concerns missing payment information from the primary payer. MA48 concerns identification and contact details.

Common causes

  • The other payer’s name was abbreviated or left blank.
  • The primary payer’s address was missing, especially on paper claims.
  • Guarantor or insured address fields were empty when the patient is not the insured.
  • Registration captured the other insurance, but it did not flow into the claim.

How to fix it

  1. Review the patient’s insurance and guarantor records for complete names and addresses.
  2. Complete the relevant claim fields, such as boxes 4, 7, 9 through 9d, and 11 through 11c, or the corresponding electronic loops.
  3. Resubmit the claim. Use resubmission code 7 in box 22 if you are replacing a processed claim.

How to prevent it

Capture full details for every payer and guarantor at registration and require them before a claim can be created. Payer-order and data issues are explored in eligibility and COB denials.

Codes that may appear with MA48

  • CO-16 (Claim/service lacks information or has submission/billing error(s).): Required claim information is missing, with MA48 identifying the responsible party or primary payer details.
  • OA-22 (This care may be covered by another payer per coordination of benefits.): The care may be covered by another payer, whose details are incomplete.
  • MA04 (Secondary payment cannot be considered without the identity of or payment information from the primary payer.): Secondary payment cannot be considered without the primary payer's identity or payment information.
  • MA92 (Missing plan information for other insurance.): Missing plan information for other insurance.
  • MA37 (Missing/incomplete/invalid patient's address.): The patient's own address is missing or invalid.

MA48 FAQ

Who is the responsible party?

Usually the insured or guarantor, the person financially responsible for the patient's account, such as a parent for a minor.

Which CMS-1500 fields cover the primary payer?

Box 11 through 11c identify the insured's group and plan, and boxes 9 through 9d identify other insurance. Electronic claims use the other-payer loops.

Is this common on Medicare Secondary Payer claims?

It can occur there, because Medicare needs the primary payer's name and address when it is billed as secondary.