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N718 Remark Code: Missing Face-to-Face Exam Record

N718 means the payer requires documentation of a face-to-face examination for this item or service and did not receive any. Submit the practitioner's encounter note for the qualifying visit and request reprocessing.

Code: N718 (RARC N718)
Status: Active In use since March 1, 2014.
Code set: Remittance Advice Remark Codes (RARC)
Group codes: CO (Contractual Obligation): The supplier or provider is responsible while the face-to-face record is missing. The patient should not be billed.
Official description: Missing documentation of face-to-face examination.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What N718 means

N718 is the “nothing received” version of the face-to-face remark. The payer’s policy requires a documented examination by a qualifying practitioner before the billed item or service, and the claim file contains no such record. Common settings include durable medical equipment, home health, and other ordered services where the ordering practitioner and the billing entity are different.

The billing entity usually has to obtain the note from someone else, which is why these denials stall. N718 normally accompanies CARC 252 or CARC 272.

Common causes

The supplier or agency collected an order and signed forms but never the underlying visit note.
The note exists but was not included in the records packet sent to the payer.
The qualifying visit never happened within the required window, so there is no note to send.

How to fix it

Confirm the requirement and window that apply to this payer and item.
Contact the ordering practitioner’s office and request the encounter note for the qualifying visit, signed and dated.
Review it before sending. It should reference the condition that supports the order.
Submit it through the payer’s records or reconsideration process with the claim number.
If no qualifying visit occurred, the claim may not be payable as billed. Check whether the payer allows a new order after a new visit, and do not bill the patient unless the payer’s rules and any required advance notice allow it.

How to prevent it

Make the face-to-face note an intake requirement: no delivery or start of care until the note is in hand and reviewed. Tracking which referring offices send incomplete packets helps target outreach. For related prerequisite denials, see authorization and referral denials.

Codes that may appear with N718

CO-252 (An attachment/other documentation is required to adjudicate this claim/service.): Documentation is required to adjudicate, and it is the face-to-face record.
CO-272 (Coverage/program guidelines were not met.): The payer's coverage guideline requiring a face-to-face visit was not met.
CO-50 (These are non-covered services because this is not deemed a 'medical necessity' by the payer.): Some payers treat an undocumented qualifying visit as a medical necessity failure.

N717 (Incomplete/Invalid documentation of face-to-face examination.): Face-to-face documentation arrived but was incomplete or invalid.
N151 (Telephone contact services will not be paid until the face-to-face contact requirement has been met.): Payment for telephone contacts waits until the face-to-face requirement is met.
M127 (Missing patient medical record for this service.): A broader missing medical record remark with no reference to a face-to-face visit.

N718 FAQ

Which claims need face-to-face documentation?

It depends on the payer. Medicare applies it to certain DME items and to home health certification, and some commercial and Medicaid plans have their own lists. Check the policy for the specific item or service.

Can the face-to-face visit happen after delivery?

Usually the visit must occur within a set window before the order or start of care. A visit after the fact generally does not satisfy the requirement, but timing rules vary by payer and program.

Is a signed order enough?

Generally no. The payer wants the clinical note from the encounter itself. An order or certification form alone is a common reason for N718.

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