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N92 Remark Code: No Digital Mammography Certification

N92 means the payer denied a digital mammography service because its records do not show the performing facility as certified for digital mammography on the date of service. The issue is the facility's certification on file, not the patient's coverage.

Quick facts

Code
N92 (RARC N92)
Status
Active In use since January 1, 2000.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The denial rests on facility certification, so the amount is typically the provider's responsibility and should not be billed to the patient.
Official description
This facility is not certified for digital mammography.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N92 means

Mammography facilities in the United States must hold certification under the Mammography Quality Standards Act, and payers such as Medicare check that the facility is certified for the type of equipment used. N92 is returned when a claim reports digital mammography but the payer cannot find a matching digital certification for the facility on the service date.

N92 usually explains a provider-eligibility reason like CARC B7. The service may be entirely appropriate; the payer simply has no record that this site was allowed to perform it digitally.

Common causes

  • The facility’s certification on file with the payer lists film only, or has not been updated after a move to digital units.
  • The certificate had lapsed or was not yet effective on the date of service.
  • The claim reported the wrong service facility or facility NPI, so the lookup hit a different location.
  • A new site opened and the payer has not loaded its certification yet.

How to fix it

  1. Confirm the certificate for the site that performed the study: its number, effective and expiration dates, and whether it covers digital equipment.
  2. Check the claim’s facility data. The service facility and its NPI (CMS-1500 box 32 and 32a) must point to the certified location.
  3. If the claim was wrong, submit a corrected claim with resubmission code 7 in box 22 and the original claim number.
  4. If the payer’s file is wrong, send the certification documentation to the payer’s provider enrollment area and ask for the claims to be reprocessed or appealed once the record is updated.

How to prevent it

Notify each payer whenever certification changes, including new units, renewals, and new sites. Keep a calendar of expiration dates for every imaging location, and confirm the service facility on mammography claims before release. The provider enrollment guide covers the wider data-mismatch problem.

Codes that may appear with N92

  • CO-B7 (This provider was not certified/eligible to be paid for this procedure/service on this date of service.): The provider was not certified or eligible to be paid for this service on this date; N92 names digital mammography as the missing certification.
  • CO-170 (Payment is denied when performed/billed by this type of provider.): Payment is denied when performed or billed by this type of provider.
  • CO-16 (Claim/service lacks information or has submission/billing error(s).): Sometimes used when the certification data on the claim itself is missing or does not match the payer's file.
  • N110 (This facility is not certified for film mammography.): The same kind of denial for film (analog) mammography.
  • N762 (This facility is not certified for Tomosynthesis (3-D) mammography.): The equivalent remark for tomosynthesis (3-D) mammography.
  • MA120 (Missing/incomplete/invalid CLIA certification number.): A certification-number problem on laboratory claims, handled through a similar data check.

N92 FAQ

Our facility is certified. Why did we get N92?

The payer's file may not reflect the certificate, its effective date, or the digital modality. Send proof of certification and ask the payer to update its records and reprocess.

Can the patient be billed?

Generally no. The denial concerns the facility's credentials, which is a provider issue.

Does N92 apply to screening and diagnostic studies?

It can apply to either, because it is about the equipment certification rather than the purpose of the exam.