How do I fix or resolve code 252?

Locate the accompanying Remittance Advice Remark Code (RARC) on the ERA/EOB to identify the specific attachment or documentation required (e.g., N656 — operative note, N523 — medical records). Retrieve the required documentation from the EHR, practice management system, or prior payer EOBs; ensure the documentation covers the date of service and procedure billed. Submit the attachment electronically via the payer's provider portal, the clearinghouse attachment service (275 transaction), or by fax/mail if electronic submission is not available; include the claim control number or DCN for matching. Track the attachment submission and follow up with the payer within 7–10 business days to confirm receipt and claim reprocessing. If the payer denies the claim after receiving the attachment, review the denial reason and determine whether an appeal or corrected claim is needed based on the new determination.

252Denial CodeGeneral Adjustment

Code 252

Problem Description

An attachment/other documentation is required to adjudicate this claim/service. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).

Root Cause

An attachment or other documentation is required to adjudicate the claim. The payer cannot process the claim without additional supporting documentation — this may include operative notes, medical records, certificates of medical necessity, itemized statements, or explanation of benefits from other payers. The claim is not denied outright; it is pended or denied pending receipt of the required documentation. The accompanying RARC will specify the exact attachment required.

Resolution Steps

1Locate the accompanying Remittance Advice Remark Code (RARC) on the ERA/EOB to identify the specific attachment or documentation required (e.g., N656 — operative note, N523 — medical records).
2Retrieve the required documentation from the EHR, practice management system, or prior payer EOBs; ensure the documentation covers the date of service and procedure billed.
3Submit the attachment electronically via the payer's provider portal, the clearinghouse attachment service (275 transaction), or by fax/mail if electronic submission is not available; include the claim control number or DCN for matching.
4Track the attachment submission and follow up with the payer within 7–10 business days to confirm receipt and claim reprocessing.
5If the payer denies the claim after receiving the attachment, review the denial reason and determine whether an appeal or corrected claim is needed based on the new determination.

EHR Documentation Note

Claim denied 252 — attachment required; identified required documentation per RARC, submitted attachment via payer portal/275 transaction, and tracked for reprocessing.

Preventative Action

Configure the practice management system to flag claims that commonly require attachments and submit documentation proactively with the initial claim to prevent pends and reduce days in A/R.

Related Codes in General Adjustment

Deductible Amount

Coinsurance Amount

Co-payment Amount

The procedure/revenue code is inconsistent with the patient's age. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

This directory provides reference information only and does not constitute official legal, medical, or financial billing advice. Always consult the payer's official remittance advice and current coding guidelines.