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N245 Remark Code: Invalid Other Insurance Plan Info

N245 means the information about the patient's other insurance plan, such as the other payer's name, policy or group number, or insured's details, was incomplete or invalid, so the payer could not coordinate benefits.

Quick facts

Code
N245 (RARC N245)
Status
Active In use since August 1, 2004; last modified March 14, 2014.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The claim was denied or held for bad coordination of benefits data. The provider corrects it; the patient should not be billed while it is correctable.
  • OA (Other Adjustment): Some payers use OA while waiting for valid other-insurance information.
Official description
Incomplete/invalid plan information for other insurance.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N245 means

To coordinate benefits, a payer needs to know which other plan covers the patient and how to identify it. N245 says the other-plan information on the claim was there in part but was not complete or not valid. Usually it accompanies CARC 16.

Where the data lives and what goes wrong

On the CMS-1500, the other insured’s name belongs in box 9, the policy or group number in 9a, and the other plan’s name in 9d. Box 11d asks whether another health benefit plan exists. Electronic claims carry the same facts in the 837’s other-subscriber information.

Frequent problems:

  • Box 11d is marked yes, but boxes 9 through 9d are blank.
  • The other plan’s name is abbreviated in a way the payer can’t recognise.
  • The policy number belongs to the patient’s own plan rather than the other insured’s plan.
  • The other insured’s name or relationship to the patient is missing.
  • Primary and secondary plans were reversed in registration.

How to fix it

  1. Confirm the patient’s other coverage directly, ideally with an eligibility check or a copy of the card.
  2. Fix registration so the order of benefits and each plan’s details are correct.
  3. Correct the other-insurance fields and submit a corrected claim with resubmission code 7 and the original claim number.
  4. If this payer is secondary, include the primary’s payment and adjustments.

See eligibility and COB denials for deeper troubleshooting.

How to prevent it

Scan front and back of every insurance card at each visit and verify coverage for all plans. Use claim edits that block submission when box 11d and boxes 9 through 9d disagree.

Codes that may appear with N245

  • CO-16 (Claim/service lacks information or has submission/billing error(s).): The claim contains missing or invalid information; N245 names the other plan data.
  • OA-22 (This care may be covered by another payer per coordination of benefits.): Another payer may be primary, and its details are needed to coordinate.
  • MA92 (Missing plan information for other insurance.): Plan information for other insurance was missing entirely.
  • MA04 (Secondary payment cannot be considered without the identity of or payment information from the primary payer.): Secondary payment cannot be considered without primary payer information.
  • MA83 (Did not indicate whether we are the primary or secondary payer.): The claim did not indicate whether this payer is primary or secondary.

N245 FAQ

Where does other insurance information go on a paper claim?

On the CMS-1500, boxes 9 through 9d hold the other insured's name, policy or group number, and the other plan's name, and box 11d indicates whether there is another health benefit plan.

Can a mismatch in box 11d cause N245?

Yes. If box 11d says there is another plan but boxes 9 through 9d are blank or incomplete, the payer may treat the other-insurance information as invalid.

What if the patient's other coverage has ended?

Remove it from the claim, update registration, and let the payer know if its records still show the coverage.