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N497 Remark Code: Permanent Impairment Report Missing

N497 means the carrier did not receive a required medical permanent impairment or disability report. These reports, common in workers' compensation, describe lasting impairment once the patient's condition has stabilized, and the related bill is held or denied without it.

Quick facts

Code
N497 (RARC N497)
Status
Active In use since July 1, 2008.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The provider owes the carrier the report. The injured person is generally not billed for this adjustment.
Official description
Missing Medical Permanent Impairment or Disability Report.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N497 means

When an injured worker’s condition stops improving, the case moves from treatment toward closure. At that point, workers’ compensation and some other injury carriers need a formal report on permanent impairment or disability: what lasting loss of function remains, how it is rated, and what future care or restrictions may be needed. That report drives settlement and benefit decisions.

N497 tells you the carrier expected this report and it did not arrive. The remark is most often attached to the bill for the evaluation itself, since the carrier pays for the evaluation when it receives the resulting report.

Common causes

  • The evaluation was billed before the written report was finished.
  • The report was sent to the attorney or employer but not to the carrier.
  • The carrier requested an impairment rating from the treating provider and the request was overlooked.
  • The report was sent without the claim number and was not linked.

How to fix it

  1. Confirm who requested the rating and which body parts or conditions it should address.
  2. Finish and sign the report using the rating method the jurisdiction requires.
  3. Submit it to the carrier and any parties the state requires, with the claim number on each page.
  4. Rebill the evaluation or request reconsideration once the report is on file, following state billing rules.
  5. Keep proof of delivery in case the report’s timing becomes an issue in the claim.

How to prevent it

Do not release a bill for an impairment evaluation until the report is complete, and send both together. Track any rating requests from adjusters with a due date. Because these reports carry significant weight in the claim, accuracy and timeliness matter more than for routine notes.

Codes that may appear with N497

  • CO-252 (An attachment/other documentation is required to adjudicate this claim/service.): An attachment is required; the missing attachment is the impairment or disability report.
  • CO-16 (Claim/service lacks information or has submission/billing error(s).): The bill lacked required information.
  • CO-226 (Information requested from the Billing/Rendering Provider was not provided or not provided timely or was insufficient/incomplete.): The carrier asked the provider for the report and did not receive it.
  • N498 (Incomplete/invalid Medical Permanent Impairment or Disability Report.): The impairment or disability report was received but was incomplete or invalid.
  • N499 (Missing Medical Legal Report.): A medical-legal report, used for disputed issues, is missing instead.
  • N495 (Missing Supplemental Medical Report.): A routine supplemental or progress report is missing.

N497 FAQ

When is a permanent impairment report written?

Usually when the treating or evaluating physician finds the patient has reached maximum medical improvement, meaning further recovery is not expected. The report then documents any lasting impairment.

Is there a standard method for rating impairment?

Many jurisdictions require a specific edition of the AMA Guides to the Evaluation of Permanent Impairment or their own rating rules. The required method depends on the state and the type of claim.

Does the evaluation have its own billing rules?

Often yes. Impairment rating evaluations may be billed under jurisdiction-specific codes or fee schedule rules. Check the state's workers' compensation fee schedule.