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N222 Remark Code: Incomplete Admitting H&P Report

N222 means the payer received the admitting History and Physical report but found it incomplete or invalid, for example unsigned, undated, missing key sections, or not matching the admission on the claim.

Quick facts

Code
N222 (RARC N222)
Status
Active In use since August 1, 2004.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The claim or days were denied or held because the H&P could not be used. The facility corrects it; the patient is not liable.
Official description
Incomplete/invalid Admitting History and Physical report.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N222 means

N222 is N221’s partner. Here the H&P arrived, but the payer could not rely on it. Reviewers look for a signed, dated document that covers the patient’s history, examination findings, assessment, and plan for this admission. If any of that is missing or the document belongs to a different stay, the payer may flag it with N222, usually alongside CARC 252.

Common causes

  • The H&P is unsigned, or the signature is missing a date or credentials.
  • The document is a template with sections left blank.
  • A pre-admission H&P was sent without the update note documenting any changes at admission.
  • The H&P date or patient identifiers don’t match the claim.
  • Pages were missing from the faxed or scanned copy.

How to fix it

  1. Compare the H&P that was sent with the one in the chart to see whether the problem was the document or the transmission.
  2. If pages were lost, resend a complete, legible copy.
  3. If a signature is missing, follow your organisation’s authentication process to obtain one, dated when it is actually signed.
  4. Include the update note if a pre-admission H&P was used.
  5. Resubmit through the payer’s attachment channel with the claim reference, and request reconsideration if the claim was already denied.

How to prevent it

Monitor unsigned and incomplete H&Ps through your health information management process before claims are billed, and perform a quick completeness check on records packets before they go to a payer.

Codes that may appear with N222

  • CO-252 (An attachment/other documentation is required to adjudicate this claim/service.): Documentation is required, and the H&P provided did not meet the payer's requirements.
  • CO-50 (These are non-covered services because this is not deemed a 'medical necessity' by the payer.): An incomplete H&P may leave the payer unable to confirm the admission was necessary.
  • N221 (Missing Admitting History and Physical report.): The admitting H&P was missing entirely.
  • N206 (The supporting documentation does not match the information sent on the claim.): The documentation does not match the information on the claim.
  • N705 (Incomplete/invalid documentation.): Incomplete or invalid documentation in general.

N222 FAQ

What makes an H&P invalid?

Common problems are a missing physician signature or date, an H&P from a different admission, missing assessment or plan, or a pre-admission H&P without the required update.

Can the physician add missing details now?

Late entries or addenda must follow your organisation's documentation rules and be clearly dated when written. They should not change what happened, only clarify it.

Is N222 different from a medical necessity denial?

Yes. N222 concerns the quality of the H&P as a document. A medical necessity denial concerns whether the admission was justified.