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N495 Remark Code: Supplemental Medical Report Missing

N495 means the carrier needed a supplemental medical report, a follow-up report updating the injury claim after the initial report, and did not receive it. Bills for the ongoing treatment may be held or denied until it is filed.

Quick facts

Code
N495 (RARC N495)
Status
Active In use since July 1, 2008.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The adjustment is for missing provider documentation. Under workers' compensation rules the injured worker generally is not billed.
Official description
Missing Supplemental Medical Report.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N495 means

After the first report on an injury claim, workers’ compensation and other property and casualty payers expect the treating provider to keep them informed. The supplemental medical report is that update. It tells the adjuster what has changed: the patient’s progress, the current diagnosis, new treatment requests, and often the latest work restrictions.

N495 says the carrier expected such a report and does not have one. Without it, the adjuster may not be able to justify continued treatment, so bills for recent visits pause.

Why the report matters to the carrier

The carrier uses supplemental reports to decide whether ongoing care is related to the accepted injury, whether new treatment should be authorized, and how to manage lost-time benefits. A bill without a current report leaves those questions open.

Common causes

  • A change in the patient’s condition or plan triggered a report requirement that was missed.
  • The adjuster requested an update and the request was not routed to the provider.
  • The report was written but attached only to the chart, not sent to the carrier.
  • The report was sent to the employer or the wrong adjuster.

How to fix it

  1. Confirm with the adjuster what triggered the request and what period the report should cover.
  2. Prepare the report in the format the jurisdiction or carrier requires, signed by the treating provider.
  3. Send it with the claim number and keep proof of delivery.
  4. Ask for reprocessing of the held bills, or resubmit them according to state billing rules.
  5. Note any deadlines the state places on reports, since late reports can affect payment in some jurisdictions.

How to prevent it

Set a reminder for each open workers’ comp case based on the state’s reporting triggers and route adjuster requests into the same task list as clinical documentation. Sending the report with the bill when a visit changes the plan avoids most N495 holds.

Codes that may appear with N495

  • CO-252 (An attachment/other documentation is required to adjudicate this claim/service.): An attachment is required; the missing attachment is the supplemental report.
  • CO-226 (Information requested from the Billing/Rendering Provider was not provided or not provided timely or was insufficient/incomplete.): The carrier requested information from the provider and did not receive it.
  • CO-16 (Claim/service lacks information or has submission/billing error(s).): The bill lacked information needed for adjudication.
  • N496 (Incomplete/invalid Supplemental Medical Report.): The supplemental report was received but incomplete or invalid.
  • N493 (Missing Doctor First Report of Injury.): The initial Doctor's First Report of Injury is missing.
  • N503 (Missing Work Status Report.): A work status report, a narrower document, is missing.

N495 FAQ

What is a supplemental medical report?

It is a follow-up report that updates the carrier on the injured person's condition, treatment, and plan after the initial report. States and carriers use different names, such as progress report, and set their own triggers for when one is due.

When do carriers require one?

Common triggers include a significant change in condition, a new treatment recommendation, a change in work status, a request from the adjuster, or a set interval. Check the jurisdiction's rules.

Is N495 only for workers' compensation?

It is used mainly by workers' compensation and other property and casualty payers. Group health plans rarely need these reports.