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N285 Remark Code: Referring Provider Name Missing

N285 means the referring provider's name was missing, incomplete, or invalid. The payer requires the name of the clinician who referred the patient, and what was on the claim did not satisfy its edit or match the referring NPI.

Quick facts

Code
N285 (RARC N285)
Status
Active In use since December 2, 2004.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The billing provider corrects the referring provider name; the amount cannot be billed to the patient.
Official description
Missing/incomplete/invalid referring provider name.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N285 means

When a patient comes to you on referral, many payers want the claim to show who referred them. Box 17 of the CMS-1500 holds the referring clinician’s name, with a qualifier in front (DN for referring). N285 means that name was blank, partial, or failed a match against the NPI in box 17b or the payer’s records.

It commonly accompanies CARC 16. The service has not been judged on coverage.

Common causes

  • No qualifier or the wrong one. The name was entered without DN, or with a qualifier indicating an ordering or supervising provider.
  • Credentials in the name. “Smith MD” in the last-name field doesn’t match NPPES.
  • Informal names. A referral slip said “Dr. Bob Jones,” but the registered name is Robert.
  • Stale referral directory. The referring clinician changed their legal name.
  • Name without NPI (or vice versa). Half-filled referring data looks invalid to many payers.

How to fix it

  1. Check the referral or intake notes for the referring clinician.
  2. Look up the clinician’s NPI in NPPES and copy the registered name.
  3. Enter the qualifier DN, the name in box 17, and the NPI in box 17b, or the equivalent 837P fields.
  4. Resubmit a corrected claim with frequency code 7 in box 22 and the original claim reference.

If the referral itself was missing or expired, fixing the name won’t help; see authorization and referral denials.

How to prevent it

Choose referring clinicians from a directory keyed by NPI instead of typing names. Refresh that directory periodically against NPPES. Add a claim edit that blocks any claim with a referring name but no NPI, or an NPI but no name.

Codes that may appear with N285

  • CO-16 (Claim/service lacks information or has submission/billing error(s).): Missing or invalid information; N285 isolates the referring provider's name.
  • CO-183 (The referring provider is not eligible to refer the service billed.): The referring provider was identified but is not eligible to refer the billed service.
  • N286 (Missing/incomplete/invalid referring provider primary identifier.): The referring provider's NPI is the problem.
  • N575 (Mismatch between the submitted ordering/referring provider name and the ordering/referring provider name stored in our records.): The submitted ordering or referring name does not match the payer's stored name.
  • N264 (Missing/incomplete/invalid ordering provider name.): The ordering provider's name, rather than a referring provider, is the problem.

N285 FAQ

Where does the referring provider name go?

Box 17 on the CMS-1500, preceded by the DN qualifier. The referring NPI goes in box 17b. Electronically, the name and NPI go in the referring provider section of the 837P.

Is a referring provider required on every claim?

No. It is required when the payer or service type calls for one, for example consultations, specialist visits under plans that require referrals, or certain diagnostic services.

Should I include 'Dr.' or 'MD'?

No. Enter the name only, without titles or credentials, in the order your form or software expects.