N479: Missing Explanation of Benefits/Adjudication or Payment Information from Prior Payer
The payer needs to see how another insurer already adjudicated this claim, most often for coordination of benefits or Medicare Secondary Payer processing, and that documentation was not included.
Corrective actions
- 1
Attach the prior payer's EOB or 835
Obtain the primary payer's remittance detail showing paid and adjusted amounts and include it with the secondary claim submission.
- 2
Confirm the coordination of benefits sequence is current
If the prior payer information on file with this payer is outdated, update the COB record before resubmitting so future claims process without this delay.
Usually paired with
Retrieved 2026-07-18.
Scrub the next claim before it denies
Free, one claim at a time, entirely in your browser.
DenialPath provides billing and administrative guidance based on published CMS and X12 sources. It is not medical advice, not a coverage determination, and not a guarantee of payment. NCCI and MUE edits are republished quarterly and payer policies vary by contract. Always confirm against the payer's own current policy before submitting or appealing.