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N393 Remark Code: Missing Progress Notes or Report

N393 means the payer needed progress notes or a progress report to process the claim, and none were received.

Quick facts

Code
N393 (RARC N393)
Status
Active In use since August 1, 2007; last modified July 1, 2008.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The claim is denied until the progress documentation is received. The provider sends it; the patient is not billed.
Official description
Missing progress notes/report.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N393 means

For ongoing treatment, payers often want proof that care is working before they pay for more. That proof is the progress note or progress report. N393 says the payer needed this documentation for the claim and it wasn’t received.

It commonly pairs with CARC 252, 163, or 226.

Common causes

  • The payer requires progress reports at set intervals and none was sent with the claim.
  • A records request arrived and wasn’t answered in time.
  • Documentation was sent, but not linked to the claim (no claim number or attachment control number).
  • The clinician hadn’t finalized the progress report when the claim went out.

What to do

  1. Check what was asked for. Daily notes, a periodic progress report, or both? The request or payer policy will say.
  2. Pull signed notes covering the dates of service billed, and the most recent progress report for that period.
  3. Make sure the report is meaningful. It should state goals, measurable progress, and the plan. Reviewers look for evidence that continued care is justified.
  4. Send them through the payer’s attachment process with the claim number and patient identifiers.
  5. Confirm receipt and track reprocessing.

If progress notes were never written for the period, talk with the clinical team before responding; don’t create documentation after the fact to fill the gap.

How to prevent it

Schedule progress reports according to each payer’s interval, and hold claims when a required report isn’t signed. For payers that always ask, attach the progress report to the claim when it’s due so the request never has to be made.

Codes that may appear with N393

  • CO-252 (An attachment/other documentation is required to adjudicate this claim/service.): Documentation is required; N393 says it's progress notes or a report.
  • CO-163 (Attachment/other documentation referenced on the claim was not received.): The attachment referenced on the claim was not received.
  • CO-226 (Information requested from the Billing/Rendering Provider was not provided or not provided timely or was insufficient/incomplete.): Information requested from the provider was not provided or not provided timely.
  • N394 (Incomplete/invalid progress notes/report.): Used when progress notes were received but are incomplete or invalid.
  • N465 (Missing Physical Therapy Notes/Report.): Covers missing physical therapy notes or reports specifically.
  • N461 (Missing Nursing Notes.): Used when nursing notes are missing.

N393 FAQ

What is a progress report?

It is documentation summarizing the patient's response to treatment over a period, including goals, progress, and the plan going forward. Some payers require it at set intervals for ongoing care.

Are daily notes enough?

Not always. If the payer asked for a progress report, send the periodic summary; include daily notes if it asked for them too.

When do payers usually ask for progress notes?

Often for therapy, behavioral health, home health, and other recurring services where continued coverage depends on documented progress.