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N499 Remark Code: Medical-Legal Report Missing

N499 means the carrier did not receive a medical-legal report. These reports address disputed questions in a workers' compensation or other injury claim, such as causation or disability, and the evaluation is usually not paid until the report is received.

Code: N499 (RARC N499)
Status: Active In use since July 1, 2008.
Code set: Remittance Advice Remark Codes (RARC)
Group codes: CO (Contractual Obligation): The bill is held or denied for a missing report the evaluator must supply. The injured person is not billed.
Official description: Missing Medical Legal Report.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What N499 means

In workers’ compensation, disputes are common: whether an injury arose from work, how disabled the worker is, whether surgery is reasonable. Many jurisdictions resolve those disputes with a medical-legal evaluation by a qualified evaluator, and the output of that evaluation is the medical-legal report. The report, not the exam alone, is what the carrier pays for.

N499 says the bill for such an evaluation arrived without its report, or the carrier cannot locate the report. It is a property and casualty remark and does not apply to group health care.

Common causes

The evaluation was billed before the report was finalized and served.
The report was served on the attorneys but not on the carrier or its bill reviewer.
The report was sent without the claim number or with the wrong one.
A supplemental medical-legal report was billed without the supplemental report attached.

How to fix it

Confirm the claim number, carrier, and bill review company handling the evaluation.
Send the complete, signed report with any required declarations or attestations the state specifies.
Attach proof of service if the jurisdiction requires it.
Rebill or request reconsideration following the state’s medical-legal billing rules and deadlines.
Use the jurisdiction’s dispute process if the carrier still does not pay after receiving the report.

How to prevent it

Bill medical-legal evaluations only after the report is signed and served, and send the report and bill together. Evaluators who work in multiple states should keep a reference for each jurisdiction’s report requirements, billing codes, and deadlines.

Codes that may appear with N499

CO-252 (An attachment/other documentation is required to adjudicate this claim/service.): A required attachment is missing; the attachment is the medical-legal report.
CO-16 (Claim/service lacks information or has submission/billing error(s).): The bill lacked information needed for adjudication.
CO-P13 (Payment reduced or denied based on workers' compensation jurisdictional regulations or payment policies, use only if no other code is applicable.): The adjustment rests on workers' compensation jurisdictional rules for medical-legal evaluations.

N500 (Incomplete/invalid Medical Legal Report.): The medical-legal report was received but incomplete or invalid.
N497 (Missing Medical Permanent Impairment or Disability Report.): A permanent impairment or disability report is missing instead.
N590 (Missing independent medical exam detailing the cause of injuries sustained and medical necessity of services rendered.): An independent medical exam report is missing, used mainly on auto and liability claims.

N499 FAQ

How is a medical-legal report different from a treating report?

A treating report documents care. A medical-legal report is prepared to resolve a disputed issue in the claim, such as whether the injury is work related, the extent of disability, or the need for future care.

Are medical-legal evaluations billed differently?

In some states, yes. California, for example, has a separate medical-legal fee schedule with its own billing rules. Check the jurisdiction before billing.

Who needs to receive the report?

Often more than the carrier. Depending on the state, the parties or their attorneys may also need copies. Follow the jurisdiction's service rules.

Important: read before using this information

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