Remark code N390 indicates that the service or report provided cannot be billed as a separate charge.
Remark code N390 indicates that the service or report in question is not eligible for individual billing and must be included as part of a larger claim or service package.
Common causes of code N390 are:
1. The service or report provided is considered part of a larger, comprehensive service already billed or to be billed, and thus cannot be billed as a separate entity.
2. Incorrect use of billing codes, where a more appropriate code that includes the service/report as part of a bundled service should have been used.
3. Lack of understanding or misinterpretation of payer-specific billing guidelines that outline which services can be billed separately versus those that are included in a comprehensive or bundled service.
4. The service or report was provided during a global surgery period or similar bundled service period, where most ancillary services are considered included in the primary service's reimbursement.
5. Failure to append the correct modifiers to the billing code, which might have allowed for separate billing under specific circumstances.
6. The service or report is considered incidental to the main service provided and does not warrant separate billing according to standard coding practices or payer policies.
Ways to mitigate code N390 include ensuring that billing staff are thoroughly trained in bundling rules and the Correct Coding Initiative (CCI) edits. Regular audits of billing practices can help identify and correct patterns that lead to this code being triggered. Utilizing updated billing software that automatically flags potential bundling issues before claims are submitted can also prevent this issue. Additionally, fostering clear communication between clinical and billing departments to ensure that all services are appropriately documented and coded as part of a comprehensive treatment plan can help avoid this denial reason.
The steps to address code N390 involve a multi-faceted approach to ensure proper billing and reimbursement. Initially, review the patient's medical records and the services provided to identify if the billed service was indeed part of a larger, bundled service. If the service was incorrectly billed as separate, consolidate it with the main service and resubmit the claim. In cases where it's unclear why the service was considered non-separable, reach out to the payer for clarification on their bundling policies. Additionally, evaluate your coding practices to ensure that all services are coded accurately according to the latest coding guidelines and payer-specific billing rules. Training staff on updated bundling rules and utilizing coding software that flags potential bundling issues can prevent future occurrences of this code.
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