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N487 Remark Code: Prosthetic or Orthotic Cert Missing

N487 means the payer required a certification for a prosthetic or orthotic item, generally a signed statement or form from the treating practitioner supporting the need for the device, and it was not received. Submit the certification and refile.

Quick facts

Code
N487 (RARC N487)
Status
Active In use since July 1, 2008.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The supplier is responsible for obtaining the certification, so the amount is not normally billed to the patient while it is correctable.
Official description
Missing Prosthetics or Orthotics Certification.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N487 means

Prosthetic limbs, braces, and other orthotic devices are expensive and often custom, so payers want clinical confirmation that the patient needs them before paying. For many plans that confirmation takes the form of a certification: a signed statement or payer form from the treating practitioner describing the patient’s condition and why the device is necessary.

N487 says that certification was not received. It is attached to the device line, usually with CARC 252 or CARC 16, and means the claim is incomplete rather than that the device was found unnecessary.

Common causes

  • The supplier had the order but not the separate certification the payer requires.
  • The practitioner’s office never returned the completed form.
  • The certification was kept on file but the payer’s policy required it to be submitted with the claim.
  • A replacement or repair was billed without a new certification when the payer requires one.

How to fix it

  1. Look up the payer’s requirement for the specific item, including which form it wants and who can sign it.
  2. Request the certification from the treating practitioner, along with supporting chart notes if the payer requires them.
  3. Verify the details: patient, item description, dates, practitioner signature and date, and any measurements or functional information requested.
  4. Resubmit the certification with a corrected claim or through the payer’s attachment process, referencing the original claim.
  5. Appeal if it was already sent, with proof of the original submission.

How to prevent it

Make the certification part of intake for every prosthetic and orthotic order. Do not deliver or bill until the signed paperwork is in hand when the payer requires it, and keep a checklist by payer. Claims that go out with every required document attached avoid most N487 denials, and a pre-submission check in the Claims Validator can flag lines that need attachments.

Codes that may appear with N487

  • CO-252 (An attachment/other documentation is required to adjudicate this claim/service.): A required attachment is missing; the remark identifies it as the prosthetics or orthotics certification.
  • CO-16 (Claim/service lacks information or has submission/billing error(s).): The claim was missing information needed to adjudicate it.
  • CO-173 (Service/equipment was not prescribed by a physician.): Used when the payer finds no evidence a physician prescribed the item.
  • N488 (Incomplete/invalid Prosthetics or Orthotics Certification.): A certification was received but was incomplete or invalid.
  • M60 (Missing Certificate of Medical Necessity.): Missing Certificate of Medical Necessity, used for certain DME items.
  • N455 (Missing Physician Order.): Missing physician order, which is a separate document from a certification.

N487 FAQ

Is a prescription enough?

Not always. Some payers want a separate certification or statement of medical need in addition to the order. Check the payer's prosthetic and orthotic policy for the item billed.

Who completes the certification?

The treating physician or other practitioner the payer allows. The supplier can prepare forms, but the clinical attestations must come from the practitioner.

Does N487 apply to off-the-shelf braces too?

It can. Whether a certification is required depends on the payer and the item, not on whether the device is custom or prefabricated.