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N796 Remark Code: Missing or Invalid Hemoglobin Value

N796 means the payer needed a patient's hemoglobin (Hb or Hgb) lab value on the claim and it was missing, incomplete, or invalid. Payers use the reading to decide whether drugs such as erythropoiesis-stimulating agents are payable, most often for dialysis and anemia treatment.

Quick facts

Code
N796 (RARC N796)
Status
Active In use since November 1, 2017.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The line was denied for missing clinical data. The provider can correct the claim, so the amount is not billed to the patient.
Official description
Missing/incomplete/invalid Hemoglobin (Hb or Hgb) value.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N796 means

Hemoglobin is the oxygen-carrying protein in red blood cells, and its level is the standard measure of anemia. For some services, payers won’t decide coverage without seeing that number. The clearest case is erythropoiesis-stimulating agents (ESAs) given to raise red blood cell production: payment rules for these drugs often depend on the patient’s recent hemoglobin or hematocrit reading.

N796 tells you that the reading was expected and either wasn’t on the claim, was incomplete, or couldn’t be accepted. It typically accompanies CARC 16. Its twin for hematocrit is N764.

Common causes

  • Lab value not carried to the claim. The result is in the chart or lab system, but no one entered it in the claim’s measurement field.
  • Invalid format. A value with the wrong decimal placement, units, or an out-of-range number the payer’s edit rejects.
  • Wrong measurement type. A hematocrit was reported where the payer’s edit was looking for hemoglobin.
  • Stale reading. The reading reported falls outside the payer’s look-back window for the date the drug was given.

How to fix it

  1. Find the qualifying lab result closest to, and before, the date of service.
  2. Confirm where the payer wants it. Electronic professional claims carry test results in a line-level measurement field; institutional dialysis claims typically use value codes. Paper claims may use box 19 if the payer allows.
  3. Enter the value in the payer’s required format and with the correct measurement type.
  4. Submit a corrected claim with resubmission code 7 in box 22 and the original claim number.

How to prevent it

  • Build an interface or charge rule that pulls the latest hemoglobin result onto every ESA or dialysis claim line.
  • Add a claim edit that stops ESA lines without a hemoglobin or hematocrit value.
  • Recheck payer policies each year, since look-back windows and thresholds can change.

Codes that may appear with N796

  • CO-16 (Claim/service lacks information or has submission/billing error(s).): The claim lacks information needed for adjudication; N796 names the hemoglobin value.
  • CO-50 (These are non-covered services because this is not deemed a 'medical necessity' by the payer.): If the reported value doesn't meet the payer's coverage criteria, the drug may be denied as not medically necessary.
  • N764 (Missing/incomplete/invalid Hematocrit (HCT) value.): The companion code for a missing or invalid hematocrit value.
  • M107 (Payment reduced as 90-day rolling average hematocrit for ESRD patient exceeded 36.5%.): A dialysis-specific reduction based on a rolling hematocrit average.
  • M119 (Missing/incomplete/invalid/ deactivated/withdrawn National Drug Code (NDC).): A missing or invalid NDC, another data element often required on drug lines.

N796 FAQ

Which claims need a hemoglobin value?

Most often claims for erythropoiesis-stimulating agents and dialysis services, where payers tie coverage or dosing rules to the patient's anemia level. Requirements vary by payer.

Which hemoglobin reading should I report?

Payers usually want the most recent reading before the drug was given, within a time window they define. Check the payer's policy for the exact rule.

Can I report hematocrit instead?

Some payers accept either value; others require one specifically. If the payer returned N796, it expected a hemoglobin value.