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N792 Remark Code: Incomplete or Invalid H&P Report

N792 means the payer received a history and physical (H&P) report for the service but found it incomplete or invalid, for example unsigned, undated, illegible, or for a different date or patient. A complete, valid H&P is needed before the claim can be paid.

Quick facts

Code
N792 (RARC N792)
Status
Active In use since July 1, 2017.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The service was denied or held because the documentation was deficient. It is the provider's to correct and not billable to the patient.
Official description
Incomplete/invalid history & physical report.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N792 means

N792 is the second half of a pair. Where N791 says the history and physical is missing, N792 says it arrived but the payer couldn’t use it. The reviewer opened the document and found something wrong with it as evidence for this claim.

That usually happens under CARC 252 (documentation required) or CARC 16 (claim lacks information). The claim can generally be paid once a complete and valid H&P is on file, assuming the documentation supports the service.

What makes an H&P “incomplete or invalid”

Payer requirements vary, but reviewers commonly reject an H&P when:

  • It isn’t authenticated. No signature, or a signature the payer can’t attribute to a qualified clinician.
  • It’s out of date range. The report is too old relative to the procedure or admission under the payer’s or facility’s rules.
  • Pages are missing or illegible, such as a partial fax or a scan that cut off the exam findings.
  • It belongs to someone or something else: another patient, another encounter, or a different date of service.
  • Required elements are absent, such as the physical exam or the assessment and plan.

How to fix it

  1. Ask the payer what was deficient if the remittance or letter doesn’t say. Fixing the wrong thing wastes a submission.
  2. Retrieve the complete, signed H&P that matches the patient and date of service.
  3. Resend it through the payer’s attachment channel, referencing the claim number on every page.
  4. If the claim is finalized, file a reconsideration or appeal with the complete report and a short cover letter explaining what was corrected.
  5. Do not alter the original record. If an addendum is appropriate, it must be clearly dated as a late entry.

How to prevent it

  • Check signatures, dates, and page counts before any record leaves the office.
  • Build a short pre-send checklist for payer records requests: correct patient, correct date, every page legible.
  • Track N791 and N792 together so you can see whether your problem is sending documents at all or sending the right ones.

Codes that may appear with N792

  • CO-252 (An attachment/other documentation is required to adjudicate this claim/service.): Documentation is required; N792 says the H&P you sent didn't satisfy the requirement.
  • CO-16 (Claim/service lacks information or has submission/billing error(s).): The claim lacks usable information for adjudication.
  • CO-50 (These are non-covered services because this is not deemed a 'medical necessity' by the payer.): When the H&P doesn't support the service, the payer may deny it as not medically necessary.
  • N791 (Missing history & physical report.): The H&P was not received at all.
  • N222 (Incomplete/invalid Admitting History and Physical report.): The admitting H&P for an inpatient stay was incomplete or invalid.
  • CO-B12 (Services not documented in patient's medical records.): The service itself is not documented in the medical record.

N792 FAQ

How is N792 different from N791?

N791 means the payer never got an H&P. N792 means it got one but couldn't accept it as sent.

Can I add missing information to the H&P and resend it?

You can send a properly dated and signed late entry or addendum if your organization's documentation policy allows it, but you should not alter the original note. The payer decides whether a late addendum supports the claim.

Does N792 mean the service wasn't medically necessary?

Not by itself. It means the report was unusable. If the payer reviewed a usable report and still disagreed with the service, you would typically see a medical-necessity reason such as CARC 50.