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MA92 Remark Code: Other Insurance Plan Info Missing

MA92 means the claim indicated other insurance but did not include the plan information the payer needs for that coverage, such as the insurer name, plan identifier, or group number. Add the other-insurance details and resubmit.

Quick facts

Code
MA92 (RARC MA92)
Status
Active In use since January 1, 1997; last modified February 1, 2004.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The claim was returned because other coverage details were missing. The provider corrects it; the patient is not billed.
Official description
Missing plan information for other insurance.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What MA92 means

MA92 tells you the claim referenced other coverage, or the payer knows of other coverage, but the plan information for that insurance was missing. Without it, the payer cannot coordinate benefits or route the claim correctly. It usually appears with CARC 16 or CARC 22. X12 lists N245 as its related code for incomplete or invalid plan information.

Common causes

  • Only the other insurer’s name was entered, with no policy or group number.
  • The other coverage was added to the account after the claim was created.
  • Other payer loops were dropped from the 837 by the billing system or clearinghouse.
  • The patient provided a card for the secondary plan, but the details were never keyed in.

How to fix it

  1. Verify the other coverage with the patient and via eligibility tools.
  2. Complete the other-insurance fields: insurer, insured’s name, policy and group numbers, and relationship.
  3. Include prior payment details if the other plan is primary.
  4. Resubmit. Use resubmission code 7 in item 22 with the original claim number when replacing a processed claim.

How to prevent it

  • Require complete plan details whenever a second coverage is added to an account.
  • Check that claim output contains all other-payer loops after system changes.
  • A pre-submission Claims Validator can flag incomplete other-insurance sections. For more, see eligibility and COB denials.

Codes that may appear with MA92

  • CO-16 (Claim/service lacks information or has submission/billing error(s).): The claim lacks information needed to adjudicate, with MA92 pointing to the other insurance plan.
  • OA-22 (This care may be covered by another payer per coordination of benefits.): Care may be covered by another payer, and the plan information is needed to coordinate.
  • N245 (Incomplete/invalid plan information for other insurance.): Related per X12: the other-insurance plan information was present but incomplete or invalid.
  • MA85Deactivated (Our records indicate that a primary payer exists (other than ourselves); however, you did not complete or enter accurately the insurance…): A primary payer exists but the other-insurance fields were left blank entirely.
  • MA99 (Missing/incomplete/invalid Medigap information.): Missing or invalid Medigap information specifically.
  • MA68 (Alert: We did not crossover this claim because the secondary insurance information on the claim was incomplete.): An alert that crossover failed because secondary insurance information was incomplete.

MA92 FAQ

What plan information is expected?

Typically the other insurer's name or identifier, the insured's policy and group numbers, and the insured's name. On the CMS-1500 this is items 9-9d and 11-11d, depending on the order of coverage.

How is MA92 different from N245?

MA92 means plan information is missing. N245 means it was provided but incomplete or invalid. X12 lists them as related codes.

What if the patient no longer has other insurance?

Remove the terminated coverage from the account and claim. If the payer's records still show it, the patient may need to contact the payer to update them.