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N208 Remark Code: Missing or Invalid DRG Code

N208 means the diagnosis-related group (DRG) code on an institutional claim was missing, incomplete, or invalid. Payers that require the hospital to report the DRG cannot price the inpatient stay without a valid one.

Quick facts

Code
N208 (RARC N208)
Status
Active In use since June 30, 2003; last modified March 14, 2014.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The inpatient claim was denied or held for a data problem. The hospital corrects and resubmits; the patient is not responsible.
Official description
Missing/incomplete/invalid DRG code.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N208 means

A diagnosis-related group classifies an inpatient stay based on diagnoses, procedures, age, discharge status, and other factors, and many payers use it to set the payment. Some payers expect the hospital to report the DRG on the UB-04 or 837I; the paper form has a PPS code field (form locator 71) for this. N208 says the value was absent, incomplete, or not acceptable. It usually explains CARC 16.

This remark applies to institutional inpatient claims. It does not relate to physician or CMS-1500 billing.

Common causes

  • The payer requires a hospital-reported DRG and the field was left blank.
  • The DRG was produced with the wrong grouper or version for the payer or discharge date.
  • A late change to diagnoses or procedures altered the DRG, but the claim kept the old value.
  • The DRG reported does not agree with the claim’s discharge status or patient age.
  • A DRG was reported for a unit or stay that is exempt from DRG payment.

How to fix it

  1. Confirm whether this payer requires the DRG and which grouping system and version it uses.
  2. Re-run the grouper using the final coded record and the payer’s settings.
  3. Verify that discharge status, admission and discharge dates, and principal diagnosis match the record.
  4. Submit a replacement claim (type of bill ending in 7) with the corrected DRG and the original claim number.
  5. If you believe your DRG is right and the payer’s differs, request a DRG validation review or file an appeal with the coding documentation.

How to prevent it

Keep a payer matrix showing who requires a reported DRG and which grouper applies, and run edits that compare the claim’s DRG against a fresh grouping before release. Coding and billing teams should agree on who updates the DRG after late coding changes.

Codes that may appear with N208

  • CO-16 (Claim/service lacks information or has submission/billing error(s).): The claim lacks information needed to adjudicate; N208 names the DRG.
  • CO-146 (Diagnosis was invalid for the date(s) of service reported.): A diagnosis was invalid for the dates of service, which can make a grouped DRG invalid too.
  • N213 (Missing/incomplete/invalid facility/discrete unit DRG/DRG exempt status information.): Missing or invalid facility or discrete unit DRG or DRG-exempt status information.
  • N647 (Adjusted based on diagnosis-related group (DRG).): Payment was adjusted based on the DRG.
  • MA30 (Missing/incomplete/invalid type of bill.): Missing or invalid type of bill, another institutional header element.

N208 FAQ

Doesn't the payer assign the DRG?

Many payers, including Medicare, run their own grouper and assign the DRG themselves. Others, such as some Medicaid programs and commercial contracts, require the hospital to report it on the claim.

Which DRG version should we use?

Use the grouper and version the payer specifies for the discharge date. Payers may use MS-DRG, APR-DRG, or another system, and versions change over time.

Can a DRG mismatch cause N208?

Yes. If the DRG reported does not match what the payer's grouper produces from the claim's diagnoses and procedures, some payers treat it as invalid.