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N26 Remark Code: Missing Itemized Bill or Statement

N26 means the payer needs an itemized bill or statement to process the claim and did not receive one. Until it can see the individual charges behind the claim, it will not pay, or will not pay in full.

Quick facts

Code
N26 (RARC N26)
Status
Active In use since January 1, 2000; last modified July 1, 2008.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The claim or line is held or denied until the itemization arrives. The provider cannot bill the patient while the documentation can be supplied.
  • PI (Payer Initiated Reduction): Some payers, including government programs, report the missing itemization as a payer-initiated reduction. Supplying the statement is still the fix.
Official description
Missing itemized bill/statement.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N26 means

A claim form reports totals. For some claims, especially large facility bills, the payer wants to see every underlying charge before paying. N26 tells you the payer asked for (or its policy requires) an itemized bill or statement and does not have one.

It typically explains CARC 16 or CARC 252. If you indicated on the claim that the itemization would follow separately but it never arrived, the payer may use CARC 163 instead.

Common causes

  • The claim exceeded a payer threshold that triggers itemization review, and none was attached.
  • A records request was sent to the business office but not answered.
  • The itemization was sent without the claim number, so the payer could not match it.
  • The payer requires itemization for a specific service type, such as implants or high-cost drugs, and the office was unaware.

How to fix it

  1. Generate a full itemized statement from your patient accounting system for the dates on the claim.
  2. Reconcile it to the claim. The itemized total should equal the billed amount, and every line should fall within the billed dates.
  3. Send it the way the payer requests, such as an electronic attachment linked to the claim, a portal upload, or mail with a cover sheet showing the claim number.
  4. Resubmit only if the payer closed the claim and asks for a new or corrected claim (resubmission code 7) with the attachment.

How to prevent it

  • Keep a list of payers and claim types that require itemized statements.
  • Attach the itemization automatically when a claim meets those rules.
  • Monitor attachment requests so they are answered before the payer’s response window closes.

For more on missing-information denials, see the CO-16 guide.

Codes that may appear with N26

  • CO-16 (Claim/service lacks information or has submission/billing error(s).): The claim lacks information for adjudication, and N26 names the itemized statement.
  • CO-252 (An attachment/other documentation is required to adjudicate this claim/service.): An attachment is required; N26 specifies that it is the itemization.
  • CO-163 (Attachment/other documentation referenced on the claim was not received.): The itemized statement was referenced on the claim but not received.
  • N232 (Incomplete/invalid itemized bill/statement.): An itemized bill was received but was incomplete or invalid.
  • N4 (Missing/Incomplete/Invalid prior Insurance Carrier(s)): The missing document is the prior carrier's EOB rather than an itemization.
  • CO-251 (The attachment/other documentation that was received was incomplete or deficient.): The documentation received was incomplete or deficient.

N26 FAQ

What should an itemized bill show?

Usually each charge with its date of service, revenue code or procedure code, description, units, and amount, adding up to the total on the claim. Payers may have their own format requirements.

Which claims usually need an itemization?

High-dollar inpatient stays are the classic example, but payers may also request itemization for outlier claims, some supply or implant charges, out-of-network claims, or accident-related claims. Requirements vary by payer.

Is the UB-04 itself not itemized enough?

The UB-04 summarizes charges by revenue code. An itemized statement breaks those summaries down to the individual supplies, drugs, and services behind them.