CARC252ReferenceCurrentVerified Aug 15, 2026CARC 252
AR Guide workflow
Step-by-step: Missing Information
✓ Workflow verified Aug 15, 2026 · Verified via review of official sources and AR Guide practice testing — not payer policy. View the full guide
VerifySteps 1–10
Remark code(s) on the ERA/EOB — they identify the exact issue
Original submission vs. what the payer received
Edit or scrubber report for the flagged element
Missing data vs. invalid data
Unprocessable (MA130) vs. a true denial
CARC 16 and the accompanying remark code
Read the remark code(s) that accompany the denial to identify the exact issue
Compare the claim to the original submission
Check the claim scrubber or edit report for the flagged element
Confirm the corrected claim clears the original edit
ActSteps 11–14
Fix the specific flagged element and resubmit
Do not resubmit an unchanged claim expecting a different result
If the claim is unprocessable (e.g., MA130), correct it rather than appeal
Document what was corrected so the resubmission can be audited
Document & QASteps 15–20
The original claim and the corrected version
The remark code that identifies the missing element
Edit or scrubber report showing the flagged field
Document the correction reason on the account
Verify the resubmitted claim clears the original edit
Track recurring edit failures to fix the source of the error
Correct and resubmit — do not appeal: Error
A claim that lacks information or has a submission error (like CARC 16) was never fully adjudicated — payers routinely deny appeals for missing data because there is nothing to appeal yet.
If you take the wrong path: Appealing CARC 16/226/252 wastes your appeal window and delays payment. Resubmitting the identical claim returns the same denial — you must fix the flagged field first.
AR Guide explanation
What it means
The payer requires an attachment or other documentation to adjudicate the claim — the documentation was not included with the submission. A remark code usually names the document.
AR Guide knowledge
Common denial category
Missing Information — The claim was missing required information or had a submission or billing error, so the payer could not process it. This is usually a correction, not an appeal.
AR Guide knowledge
Most common causes
- Required attachment not sent with the claim
- Supporting documentation omitted from the submission
- Attachment referenced but not included
AR Guide knowledge
Action in your PM/EMR system
In your PM system: open the claim, note exactly which attachment the payer requested, send it through the payer's preferred channel (portal, fax, or mail) referencing the claim number, and track the submission — keep proof it was received.
Illustrative scenario
Real-world example
An office visit (CPT 99213) was submitted with the patient's old subscriber ID. The payer denied with CARC 16 + RARC M79 because the subscriber ID did not match their records. The fix: correct the subscriber ID in the PM system and resubmit with frequency code 7.
Example — not a claim about any specific payer or account.
AR Guide knowledge
What AR should verify
- Read the remark code to identify which attachment is required
- Confirm what documentation was submitted with the original claim
- Check the payer's preferred documentation channel and format
AR Guide knowledge
Recommended action
- Send the requested attachment through the payer's preferred channel and reference the claim number
- Track the submission so receipt can be proven later
- Resubmit the claim with the attachment if the payer requires it
Appeal template
No code-specific template yet
No downloadable template targets CARC 252 specifically. Browse all appeal letter templates — or follow the recommended workflow above.
AR Guide knowledge
Escalation
- If the payer requests documentation that does not exist or is not applicable, escalate to a supervisor.
AR Guide knowledge
QA checkpoint
- Attach required documentation at initial submission
- Confirm receipt of every documentation submission
About this guidance: Note
Priority 2
Commonly paired RARCs
RARCs commonly accompany CARC 252 on the ERA/EOB. Select the one on your line to focus the workflow, or use the list as a lookup.
RARCM129Missing/incomplete/invalid indicator of x-ray availability for review.Verify the x-ray availability indicator was submitted and resubmit with the required indicator.RARCN170A new/revised/renewed certificate of medical necessity is needed.Obtain a current CMN and resubmit, or appeal with the valid CMN for the service dates.RARCN29Missing documentation/orders/notes/summary/report/chart.Send the requested documentation through the payer's preferred channel and reference the claim number. Track the submission so it can be proven later.RARCMA130Your claim contains incomplete and/or invalid information, and no appeal rights are afforded because the claim is unprocessable. Please submit a new claim with the complete/correct information.This is not an appeal situation — fix the flagged issue and resubmit. Resubmitting the identical claim will return the same result.RARCN26Missing itemized bill/statement.RARCM60Missing Certificate of Medical Necessity.RARCN38Missing/incomplete/invalid place of service.Correct the place of service code and resubmit.RARCN57Missing/incomplete/invalid prescribing date.Verify the prescription date and resubmit with the correct date.
Priority 3
Payer-specific nuance
How major payers handle this denial — what AR Guide has verified, and what you must confirm with the payer. We never publish payer handling we have not verified.
Medicare
The exact data each payer requires, and how it must be submitted, varies. Read the remark code carefully and correct only what was flagged — verify the required format with the payer rather than guessing.
Medicaid
The exact data each payer requires, and how it must be submitted, varies. Read the remark code carefully and correct only what was flagged — verify the required format with the payer rather than guessing.
- Medicaid — Alabama (Alabama) — verified contact info
- Medicaid — Alaska (Alaska) — verified contact info
- Medicaid — Arizona (Arizona) — verified contact info
- Medicaid — Arkansas (Arkansas) — verified contact info
- Medicaid — California (California) — verified contact info
- Medicaid — Colorado (Colorado) — verified contact info
- Medicaid — Connecticut (Connecticut) — verified contact info
- Medicaid — Delaware (Delaware) — verified contact info
- Medicaid — District of Columbia (District of Columbia) — verified contact info
- Medicaid — Florida (Florida) — verified contact info
- Medicaid — Georgia (Georgia) — verified contact info
- Medicaid — Hawaii (Hawaii) — verified contact info
- Medicaid — Idaho (Idaho) — verified contact info
- Medicaid — Illinois (Illinois) — verified contact info
- Medicaid — Indiana (Indiana) — verified contact info
- Medicaid — Iowa (Iowa) — verified contact info
- Medicaid — Kansas (Kansas) — verified contact info
- Medicaid — Kentucky (Kentucky) — verified contact info
- Medicaid — Louisiana (Louisiana) — verified contact info
- Medicaid — Maine (Maine) — verified contact info
- Medicaid — Maryland (Maryland) — verified contact info
- Medicaid — Massachusetts (Massachusetts) — verified contact info
- Medicaid — Michigan (Michigan) — verified contact info
- Medicaid — Minnesota (Minnesota) — verified contact info
- Medicaid — Mississippi (Mississippi) — verified contact info
- Medicaid — Missouri (Missouri) — verified contact info
- Medicaid — Montana (Montana) — verified contact info
- Medicaid — Nebraska (Nebraska) — verified contact info
- Medicaid — Nevada (Nevada) — verified contact info
- Medicaid — New Hampshire (New Hampshire) — verified contact info
- Medicaid — New Jersey (New Jersey) — verified contact info
- Medicaid — New Mexico (New Mexico) — verified contact info
- Medicaid — New York (New York) — verified contact info
- Medicaid — North Carolina (North Carolina) — verified contact info
- Medicaid — North Dakota (North Dakota) — verified contact info
- Medicaid — Ohio (Ohio) — verified contact info
- Medicaid — Oklahoma (Oklahoma) — verified contact info
- Medicaid — Oregon (Oregon) — verified contact info
- Medicaid — Pennsylvania (Pennsylvania) — verified contact info
- Medicaid — Rhode Island (Rhode Island) — verified contact info
- Medicaid — South Carolina (South Carolina) — verified contact info
- Medicaid — South Dakota (South Dakota) — verified contact info
- Medicaid — Tennessee (Tennessee) — verified contact info
- Medicaid — Texas (Texas) — verified contact info
- Medicaid — Utah (Utah) — verified contact info
- Medicaid — Vermont (Vermont) — verified contact info
- Medicaid — Virginia (Virginia) — verified contact info
- Medicaid — Washington (Washington) — verified contact info
- Medicaid — West Virginia (West Virginia) — verified contact info
- Medicaid — Wisconsin (Wisconsin) — verified contact info
- Medicaid — Wyoming (Wyoming) — verified contact info
UnitedHealthcare
The exact data each payer requires, and how it must be submitted, varies. Read the remark code carefully and correct only what was flagged — verify the required format with the payer rather than guessing.
Aetna
The exact data each payer requires, and how it must be submitted, varies. Read the remark code carefully and correct only what was flagged — verify the required format with the payer rather than guessing.
Cigna
The exact data each payer requires, and how it must be submitted, varies. Read the remark code carefully and correct only what was flagged — verify the required format with the payer rather than guessing.
Anthem (BCBS)
The exact data each payer requires, and how it must be submitted, varies. Read the remark code carefully and correct only what was flagged — verify the required format with the payer rather than guessing.
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