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N369 Remark Code: Claim Deficient Under State Law

N369 is an alert that although the payer processed the claim, it found the claim deficient under state legislation or regulation. The payer is flagging a state requirement the claim did not meet.

Quick facts

Code
N369 (RARC N369)
Status
Active In use since April 1, 2006.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): Any adjustment on the line follows the payer's contract or state rules. The alert itself flags a compliance gap rather than assigning a balance.
Official description
Alert: Although this claim has been processed, it is deficient according to state legislation/regulation.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N369 means

States set their own rules for some claims: required data elements, forms, billing timelines, or content for certain programs such as state-regulated plans, Medicaid, or workers’ compensation. N369 tells you that the payer processed your claim anyway but found it didn’t comply with one of those rules. It is a warning that could matter for future claims or for audits.

The line’s CARC tells you what was paid or adjusted. N369 explains that a state-level problem was noted.

What to do

  1. Read the CARC on the same line to see whether payment was affected.
  2. Contact the payer to learn exactly which state requirement was not met.
  3. Check the state’s rules for that line of business, since requirements differ widely between states and programs.
  4. Update your claim templates, forms, or workflow so future claims comply.
  5. If the payer says the deficiency must be fixed on this claim, submit a corrected claim with frequency code 7 as instructed.

Keep a note of which payers and states have raised N369 so your team can review those requirements when onboarding new plans.

Codes that may appear with N369

  • CO-223 (Adjustment code for mandated federal, state or local law/regulation that is not already covered by another code and is mandated before a new code…): An adjustment for a mandated federal, state, or local law or regulation not covered by another code.
  • N883 (Alert: Processed according to state law): An alert that the claim was processed according to state law.
  • N246 (State regulated patient payment limitations apply to this service.): Says state-regulated patient payment limitations apply to the service.
  • N59 (Alert: Please refer to your provider manual for additional program and provider information.): Refers you to the provider manual for program requirements.

N369 FAQ

Was my claim denied?

Not by N369 alone. The claim was processed; check the CARC for the payment result.

How do I find out what was deficient?

Ask the payer which state requirement the claim failed. Common examples are required claim elements, forms, or billing formats set by state rules, which vary by state and line of business.

Do I need to resubmit?

Only if the payer tells you to or the deficiency affected payment. Otherwise, fix the issue on future claims.