N438 Remark Code: Jurisdiction Only Accepts Paper Claims
N438 means the jurisdiction handling this claim only accepts paper claims. The claim was sent electronically, and the payer is telling you to resubmit it on the appropriate paper form instead.
Quick facts
- Code
- N438 (RARC N438)
- Status
- Active In use since July 1, 2008; last modified March 14, 2014.
- Code set
- Remittance Advice Remark Codes (RARC)
- Group codes
-
- CO (Contractual Obligation): The claim was not processed because of its submission format. The provider refiles on paper; the patient is not billed.
- OA (Other Adjustment): Some payers report the rejected electronic submission as an other adjustment until the paper claim is received.
- Official description
This jurisdiction only accepts paper claims.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026- Last verified
- against the official X12 list.
What N438 means
Most health plans want electronic claims, but not every jurisdiction is set up for them. N438 tells you the jurisdiction that governs this claim, commonly a state workers’ compensation system, accepts only paper claims. Your electronic claim was not processed for that reason.
The remark usually appears with CARC 16. There is nothing wrong with the services themselves; only the channel needs to change.
Common causes
- Workers’ compensation or auto claims sent electronically to a carrier in a jurisdiction without electronic billing requirements.
- Clearinghouse routing that forwards every payer electronically, even when the carrier cannot accept it for this jurisdiction.
- Carrier-specific rules where the carrier accepts electronic claims in some states but not others.
- Required attachments that the jurisdiction expects with the claim, which effectively force a paper submission.
How to fix it
- Confirm the jurisdiction’s rules for the date of service: which form, whether attachments are required, and the mailing address.
- Prepare the paper claim on the correct form, with complete claim information including the carrier’s claim number and date of injury.
- Attach required documents, such as medical reports, if the jurisdiction requires them with the bill.
- Mail it with tracking and record the date sent.
- Update your payer setup so future claims for this carrier and jurisdiction print instead of transmitting.
How to prevent it
Tag workers’ compensation and property and casualty accounts with the jurisdiction at registration, and maintain a table of which carrier and state combinations accept electronic claims. Review it periodically, since states adopt electronic billing rules over time. The difference between front-end rejections and denials is explained in claim rejection vs denial.
Codes that may appear with N438
Related and easily confused codes
- N407 (You are not an approved submitter for this transmission format.): The submitter is not approved for the transmission format used, often an enrollment issue.
- N400 (Alert: Electronically enabled providers should submit claims electronically.): The opposite message: electronically enabled providers should submit electronically.
- N418 (Misrouted claim.): The claim was misrouted to the wrong payer or address.
N438 FAQ
Which payers send N438?
It is most associated with workers' compensation and other property and casualty claims, where rules are set by each state jurisdiction. Electronic billing requirements for these claims vary by state and have changed over time.
Which paper form should I use?
Professional services usually go on the CMS-1500 and facility services on the UB-04, but some jurisdictions require their own forms or additional attachments such as reports. Check the jurisdiction's billing rules.
Does the electronic submission count for timely filing?
It may help show you acted on time, but do not rely on it. Mail the paper claim promptly and keep proof of mailing.