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N460 Remark Code: Incomplete or Invalid Discharge Summary

N460 means the discharge summary was incomplete or invalid. The payer received a discharge summary, but it was unsigned, missing key content, inconsistent with the claim's dates or discharge status, or otherwise not acceptable.

Quick facts

Code
N460 (RARC N460)
Status
Active In use since July 1, 2008.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The payer needs a usable summary before it will pay. The facility resolves it; the patient is not billed.
Official description
Incomplete/invalid Discharge Summary.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N460 means

N460 tells you the discharge summary arrived but failed the payer’s review. It is paired most often with CARC 251. The problem is usually one of two kinds: the summary itself is deficient, or it contradicts what the claim says about the stay.

Where claim and summary collide

The summary and the institutional claim describe the same stay, so reviewers compare them. Watch for:

  • Discharge date. The summary shows a different date than the claim’s statement through date or discharge information.
  • Discharge destination. The summary says the patient went to a skilled nursing facility or home health, but the patient discharge status code on the claim says home, or the reverse. This can affect payment under transfer rules.
  • Length of stay. Admission and discharge dates in the summary don’t match the days billed.

Deficiencies in the document

  • Unsigned or undated summary, or one signed by someone without authority to sign.
  • Missing hospital course, discharge diagnoses, or follow-up plan.
  • A summary from a different admission.
  • A dictated but not finalized version.

How to fix it

  1. Line up the summary and the claim and note every conflict.
  2. Decide which is correct with health information management and the attending provider.
  3. Correct the claim where it was wrong, using a replacement claim (type of bill frequency code 7) with the original claim number.
  4. Get an addendum from the provider where the summary was wrong or incomplete.
  5. Resend the final summary with a cover sheet.

How to prevent it

Check discharge status codes against the discharge summary during pre-bill review. A simple comparison of dates and disposition before claims leave the facility prevents most N460 denials.

Codes that may appear with N460

  • CO-251 (The attachment/other documentation that was received was incomplete or deficient.): The documentation received was incomplete or deficient.
  • CO-250 (The attachment/other documentation that was received was the incorrect attachment/document.): The document received was not the one required.
  • N459 (Missing Discharge Summary.): The discharge summary was not received at all.
  • N452 (Incomplete/invalid Admission Summary Report.): The admission summary report was incomplete or invalid.
  • N50 (Missing/incomplete/invalid discharge information.): Discharge information on the claim is missing, incomplete, or invalid.

N460 FAQ

What does 'invalid' mean for a discharge summary?

Usually that it conflicts with the claim, such as a different discharge date or destination, or that it is not authenticated by the responsible provider.

Should I fix the claim or the summary?

Whichever is wrong. If the claim's discharge date or status code is wrong, submit a corrected claim. If the summary has an error, the provider addresses it with a dated addendum.

Can a nurse's discharge note replace the summary?

Generally not. Payers usually expect the provider's discharge summary, though nursing notes can support it.