N179 remark code
Remittance advice remark code N179. Remark codes add detail to the reason code on the same claim line.
Waiting on information from the member
Unofficial reference. This is our own plain-English explanation, not the official code text. Payer rules differ. Verify with the payer and the official X12 code list. AlphaPrefix is not affiliated with X12, CMS or any payer. Data last updated .
What N179 means
The payer is holding the charges until the patient or subscriber answers its request, then it will take another look.
N179 means the hold is on the member's side, not yours. Common examples are an accident questionnaire, other insurance details or a student status form. The claim stays denied or pended until the member responds.
It usually pairs with reason code 227 (patient did not send requested info).
Common causes
- The payer sent the member a coordination of benefits questionnaire that was not returned.
- An accident or injury questionnaire was required because of the diagnosis codes.
- The payer needs proof of dependent or student status for the member.
What to do next
- Contact the patient and ask them to answer the payer's request.
- Give the patient the payer's phone number or form so they can respond directly.
- Set a follow-up date to check whether the claim was reprocessed after the member responded.
- Note the account so statements are held while the payer waits on the member.
Related codes
- N245 (remark code) Other insurance plan details invalid
- N4 (remark code) Prior payer EOB missing or invalid
- 22 (reason code) Another payer may be primary
Source
Official wording: X12 Remittance Advice Remark Codes list. The explanation on this page is our own plain-English wording, not the X12 text.
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