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N392 Remark Code: Incomplete Emergency Department Records

N392 means the payer received emergency department records for the claim, but they were incomplete or invalid, for example missing pages, unsigned, illegible, or for the wrong date or patient.

Quick facts

Code
N392 (RARC N392)
Status
Active In use since August 1, 2007.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The claim stays denied until complete ED documentation is received. The provider supplies it; the patient is not billed.
Official description
Incomplete/invalid emergency department records.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N392 means

With N392, the records did arrive, but the reviewer couldn’t use them. Something was missing or wrong: a page, a signature, the physician note, or the right date. Because the documentation didn’t support the review, the claim was denied.

N392 usually pairs with CARC 251 (incomplete attachment) and sometimes CARC 252.

What reviewers usually expect

An ED review generally needs the full picture of the encounter:

  • Chief complaint and triage assessment, with time of arrival
  • The emergency physician’s history, exam, medical decision making, and signature
  • Orders, results, and any procedures
  • Nursing notes and medication administration
  • Disposition, including discharge instructions or admission

If the payer’s request letter lists specific items, those come first.

Common problems

  • Only the physician note was sent when the payer also needed triage and nursing documentation.
  • Electronic signatures didn’t print on the exported copy.
  • The export cut off addenda or late entries.
  • Multiple ED visits on nearby dates were mixed up.
  • Scans were too faint or skewed to read.

How to fix it

  1. Compare what you sent with the request letter and the list above.
  2. Pull a complete, signed copy of the ED record for the correct date.
  3. Check legibility and page count before sending.
  4. Resubmit through the payer’s attachment channel with the claim number and a short cover note.
  5. Track the claim until it reprocesses.

How to prevent it

Create a standard ED records packet in your health information management workflow, with a checklist for signatures and required sections. Spot-check exports so missing signatures or addenda are caught before they go out.

Codes that may appear with N392

  • CO-251 (The attachment/other documentation that was received was incomplete or deficient.): The attachment received was incomplete or deficient.
  • CO-252 (An attachment/other documentation is required to adjudicate this claim/service.): Documentation is required to adjudicate the claim.
  • N391 (Missing emergency department records.): Used when the ED records were never received at all.
  • N237 (Incomplete/invalid patient medical record for this service.): Covers an incomplete or invalid patient medical record in general.
  • N205 (Information provided was illegible.): Says the information provided was illegible.

N392 FAQ

What makes ED records incomplete?

Missing physician documentation, missing signatures, absent triage or nursing notes, cut-off pages, or records that don't cover the full visit.

What makes them invalid?

Records for a different patient or date, unreadable copies, or documents that conflict with what was billed.

Should I send the whole chart this time?

Send the complete ED encounter for that date, organized and legible. Avoid unrelated records that slow the review.