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N893 Remark Code: Child Medical Evaluation Form Issue

N893 means the child medical evaluation form or checklist the payer requires for this service was missing, incomplete, or invalid. These forms are typically program-specific, such as state Medicaid or child welfare requirements for well-child or entry exams.

Quick facts

Code
N893 (RARC N893)
Status
Active In use since March 1, 2024.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The unpaid amount while the required form is outstanding. It is the provider's responsibility to supply the form, not the family's.
Official description
Missing/incomplete/invalid child medical evaluation form/checklist.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N893 means

Some programs that pay for children’s exams want more than a claim. They require a specific evaluation form or checklist showing each required element of the exam was done, such as history, measurements, developmental screening, and referrals. The requirements come from the program, not from general coding rules.

N893 says the payer did not get a usable form for this claim. It may be absent, missing sections or signatures, or on the wrong version.

Common causes

  • The form was completed in the chart but never sent with the claim.
  • Required sections, such as screening results or the examining clinician’s signature, were left blank.
  • An outdated or practice-made version was used instead of the program’s form.
  • The form’s date, child’s name, or ID does not match the claim.

How to fix it

  1. Find the program’s current form and its instructions.
  2. Complete every required field from the visit documentation, and get the clinician’s signature where required.
  3. Send it using the payer’s attachment method, or resubmit the claim with frequency code 7 if the payer requires a corrected claim with the attachment.
  4. Confirm receipt and track the claim to payment.

How to prevent it

Build the program’s form into the visit template for children covered by that program, so it is completed during the exam and attached at billing.

Codes that may appear with N893

  • CO-16 (Claim/service lacks information or has submission/billing error(s).): The claim lacks information or has a submission error; N893 names the child evaluation form.
  • CO-252 (An attachment/other documentation is required to adjudicate this claim/service.): An attachment is required to adjudicate the claim.
  • CO-251 (The attachment/other documentation that was received was incomplete or deficient.): The attachment received was incomplete or deficient.
  • N78 (The necessary components of the child and teen checkup (EPSDT) were not completed.): The necessary components of an EPSDT child and teen checkup were not completed.
  • N706 (Missing documentation.): Documentation is missing, without naming a specific form.
  • N705 (Incomplete/invalid documentation.): Documentation was submitted but is incomplete or invalid.

N893 FAQ

What is a child medical evaluation form?

It is a structured form or checklist that documents the components of a child's medical exam. Some state programs require their own version for well-child checkups or for evaluations of children in state custody.

Where do I get the right version?

From the payer or program that requires it, usually on the state Medicaid or agency website or in the provider manual. Using an outdated version can make the form invalid.

Is N893 used for commercial plans?

It is most likely on claims to public programs. Check the payer's policy to see whether it applies.