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N476 Remark Code: Incomplete Completed Referral Form

N476 means the completed referral form was incomplete or invalid. The plan has a referral form for the patient, but it is missing information, has expired, covers a different provider or service, or has no visits left for the dates billed.

Quick facts

Code
N476 (RARC N476)
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 referral on file does not cover the service, so the specialist generally absorbs the amount under network rules. The patient is not billed unless the plan and contract allow it.
Official description
Incomplete/invalid completed referral form.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N476 means

N476 means the plan found a referral form but it doesn’t hold up for this claim. The form could be missing fields the plan requires, or it could be valid in general but not for these dates, this provider, or this number of visits. Payers commonly pair it with CARC 287 (referral exceeded) or CARC 251.

Typical defects

  • Expired. The service date falls after the referral’s end date.
  • Visits used up. The referral authorized a set number of visits, and earlier visits consumed them.
  • Wrong provider or specialty. The referral went to a different specialist, location, or group.
  • Missing fields. Diagnosis, referral number, referring provider NPI, or signature left blank.
  • Different service. The referral covers a consultation only, and treatment or procedures were billed.

How to fix it

  1. Pull the referral details from the plan’s portal: provider, dates, visit count, and scope.
  2. Compare them with the claim to find the gap.
  3. Request an updated referral from the referring office for extra visits, new dates, or broader scope, and ask the plan whether it can apply retroactively.
  4. Correct the claim if the claim was the problem, for example the wrong referring provider in box 17 or 17b, and resubmit with resubmission code 7.
  5. Appeal with evidence if the referral on file does cover the service.

How to prevent it

Track remaining visits and end dates on active referrals, and alert staff before the last covered visit. Ask the referring office for a renewal as soon as a patient’s treatment plan extends beyond the current referral.

Codes that may appear with N476

  • CO-287 (Referral exceeded): Referral exceeded, such as more visits than the referral allowed.
  • CO-251 (The attachment/other documentation that was received was incomplete or deficient.): The documentation received was incomplete or deficient.
  • CO-288 (Referral absent): Referral absent, used by some payers when the referral on file doesn't apply.
  • N475 (Missing completed referral form.): The completed referral form was not received at all.
  • N490 (Incomplete/invalid referral form.): A referral form was received but was incomplete or invalid.
  • N575 (Mismatch between the submitted ordering/referring provider name and the ordering/referring provider name stored in our records.): The ordering or referring provider name does not match the payer's records.

N476 FAQ

The referral is on file. Why was the claim denied?

A referral has limits: a provider or specialty, a date range, and often a number of visits. If the service falls outside any of those, the plan treats the referral as not covering it.

Can the referral be extended?

The referring office can often issue a new or updated referral. Whether it can apply to past dates depends on the plan.

What if the referral names our group but not our provider?

Some plans accept a group referral; others require the individual provider. Ask the plan how it matches referrals.