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N778 Remark Code: Missing Primary Care Physician Info

N778 means the payer required the patient's primary care physician information on this claim and did not receive it. Plans that assign members to a primary care physician, such as many HMO and some Medicaid managed care plans, may need this to process specialist or referred care.

Quick facts

Code
N778 (RARC N778)
Status
Active In use since November 1, 2016.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The claim was denied for missing information the provider must supply. It is not patient responsibility.
Official description
Missing Primary Care Physician Information.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N778 means

In gatekeeper-style plans, each member is assigned a primary care physician who directs their care and issues referrals. For some claims, the plan wants that PCP identified so it can confirm the care was coordinated. N778 means that information was absent from your claim.

It often pairs with CARC 16. When the plan also could not find a referral, you may see CARC 288 or CARC 243 alongside it.

Common causes

  • The claim was for specialist care, and the referring or PCP fields were left blank.
  • The practice did not capture the assigned PCP at registration.
  • The patient’s assigned PCP was different from the provider who actually referred them.
  • The plan requires PCP information in a specific claim field that the practice’s software does not populate.

How to fix it

  1. Verify the patient’s assigned PCP for the date of service through eligibility or the plan portal.
  2. Add the PCP’s name and NPI where the plan specifies, often the referring provider fields (box 17 and 17b on the CMS-1500).
  3. Confirm a referral from the PCP is on file if the plan requires one.
  4. Submit a corrected claim with resubmission code 7, or a new claim if the payer rejected the original.

How to prevent it

Capture the assigned PCP during eligibility verification for every managed care patient and store it on the account. Check referral requirements at scheduling, as outlined in authorization and referral denials.

Codes that may appear with N778

  • CO-16 (Claim/service lacks information or has submission/billing error(s).): The claim lacks information, identified here as primary care physician data.
  • CO-288 (Referral absent): A referral is absent, often linked to missing PCP information in gatekeeper plans.
  • CO-243 (Services not authorized by network/primary care providers.): Services were not authorized by network or primary care providers.
  • N922 (Missing primary care dentist information.): Missing primary care dentist information, the dental version.
  • N285 (Missing/incomplete/invalid referring provider name.): The referring provider's name is missing or invalid.
  • N286 (Missing/incomplete/invalid referring provider primary identifier.): The referring provider's primary identifier is missing or invalid.

N778 FAQ

Why would a plan need the PCP on my claim?

In plans where the primary care physician coordinates care, the payer may check that specialist or referred services came through the assigned PCP.

Where do I find the patient's assigned PCP?

The member ID card, an eligibility response, or the plan's provider portal usually shows it. Ask the patient if needed.

What if the patient's PCP changed?

Use the PCP assigned on the date of service. If the plan's record is wrong, the patient may need to contact the plan to update it.