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N446 Remark Code: Invalid Cost or Paid Amount Document

N446 means the document provided for actual cost or paid amount was incomplete or invalid. The payer received something, often an invoice, but it could not use it to price the claim because it was missing details, did not match the claim, or was not an acceptable document.

Quick facts

Code
N446 (RARC N446)
Status
Active In use since July 1, 2008.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The payer cannot price the item until a usable cost document arrives. The provider resolves it; the patient is not billed.
Official description
Incomplete/invalid document for actual cost or paid amount.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N446 means

N446 is the follow-up problem to a missing invoice. The payer did get a cost document, but it failed review. Maybe it did not show a price, listed a different product, or could not be tied to the claim line. The payer is asking for a corrected or complete document before it can calculate what to pay. Look for it with CARC 251 or CARC 250.

What payers check on a cost document

Before resubmitting, confirm your document shows:

  • the vendor or manufacturer and invoice date,
  • the product description with a catalog or item number that matches what was billed,
  • the quantity and unit price, and the net amount after discounts,
  • a clear link to the patient or claim, if the payer requires it, and
  • legible content, with all pages included.

A document missing any of these, or showing a different product or quantity than the claim, is a likely N446 trigger.

How to fix it

  1. Pull what you sent and compare it against the checklist above and the payer’s own requirements.
  2. Get a better document if needed, such as a final invoice instead of a quote or packing slip.
  3. Reconcile the claim. If the invoice is right and the claim is wrong, correct the billed code, units, or description and submit a corrected claim with resubmission code 7.
  4. Resend through the payer’s attachment channel with the claim number on each page.
  5. Call the payer if you cannot tell what was deficient; ask specifically what field or element failed review.

How to prevent it

Standardize what goes out: one invoice per item, with the relevant line marked, net price shown, and the claim number written on it. Train staff to reject packing slips and quotes as substitutes for invoices.

Codes that may appear with N446

  • CO-251 (The attachment/other documentation that was received was incomplete or deficient.): The attachment received was incomplete or deficient.
  • CO-250 (The attachment/other documentation that was received was the incorrect attachment/document.): The attachment received was the wrong document, and the expected one is still missing.
  • CO-16 (Claim/service lacks information or has submission/billing error(s).): A billing error or missing information prevents adjudication.
  • N445 (Missing document for actual cost or paid amount.): The cost document was not received at all.
  • N350 (Missing/incomplete/invalid description of service for a Not Otherwise Classified (NOC) code or for an Unlisted/By Report procedure.): The description of an unlisted or not otherwise classified service is missing or invalid.

N446 FAQ

Why would an invoice be invalid?

Common reasons are a missing price or quantity, a different item than billed, no date or vendor, an illegible copy, or a quote or price list sent instead of an actual invoice.

Can I send a price list or catalog page?

Usually not. Payers typically want proof of what was actually paid for the specific item, not a list price. Check the payer's policy.

What if the invoice covers many items?

Highlight or mark the line for the billed item and make sure the quantity billed matches. Unclear multi-item invoices are a frequent cause of N446.