Denial code N474

Remark code N636 is an adjustment notice indicating a service is only reimbursable once per injury.

Remark code N637 is an alert that consultations by the same provider post-treatment are not permitted for billing.

Remark code N638 indicates payment was adjusted based on the home health fee schedule.

Remark code N639 indicates payment was aligned with the inpatient rehab facility fee schedule.

Remark code N64 indicates that a claim's 'from' and 'to' dates of service must not be the same for processing.

Remark code N640 indicates a claim exceeds the number or frequency of services approved or allowed within a specific time period.

Remark code N641 is an explanation for reimbursement based on the rated body areas.

Remark code N642 is an adjustment for billing individual tests rather than as a panel, affecting reimbursement.

Remark code N643 indicates services billed are not covered in the state's fee schedule, meaning they're ineligible for payment.

Remark code N644 indicates payment was adjusted following the bilateral procedure rule, affecting reimbursement amounts.

Remark code N645 is an indication that a mark-up allowance has been applied to the healthcare service billing.

Remark code N646 indicates reimbursement adjustment due to assistant guidelines.

Remark code N647 is an adjustment notice indicating billing changes based on the diagnosis-related group (DRG) classification.

Remark code N648 is an adjustment notice indicating billing reached the stop loss limit set by the payer's policy.

Remark code N649 is an indication that payment was determined according to the submitted invoice details.

Remark code N65 indicates a claim issue where the procedure code/rate count is undetermined or not on file for the service date/provider.

Remark code N650 indicates a claim denial because the policy was inactive on the date of the incident. Coverage is unavailable.

Remark code N651 indicates a lack of Personal Injury Protection/Medical Payments Coverage in the policy during the loss event.

Remark code N652 is an alert indicating the service date precedes the loss date, requiring verification or correction.

Remark code N653 is an alert that the injury date and reported loss date do not align, requiring verification.

Remark code N654 is an adjustment notice indicating maximum medical improvement (MMI) has been achieved, affecting payment.

Remark code N655 is an explanation for payment adjustments based on the provider's geographic location.

Remark code N656 indicates an interest payment due to benefits paid beyond the statutory requirement.

Remark code N657 is an alert indicating services must be billed with the correct procedural code for acceptance.

Remark code N658 is an alert that the billed services are not recognized as medical expenses by the payer.

Remark code N659 indicates an item is not subject to sales tax, clarifying billing and payment processing for healthcare providers.

Remark code N660 indicates that the reimbursement amount already includes sales tax.

Remark code N661 indicates that the provided documentation fails to prove the medical necessity of the services billed.

Remark code N662 is an alert indicating payment consideration awaits the submission of a final bill.

Remark code N663 is an adjustment notice indicating a payment change due to a pre-negotiated agreement.

Remark code N664 is an adjustment due to a legal settlement affecting the claim's reimbursement.

Remark code N665 indicates that services from an unlicensed provider are not eligible for reimbursement.

Remark code N666 indicates that only one evaluation and management code at this service level is covered during the care course.

Remark code N667 is an alert indicating a claim's denial due to the absence of a required prescription.

Remark code N668 indicates an incomplete or invalid prescription, signaling a need for additional information or correction.

Remark code N669 is an adjustment notice indicating billing was aligned with the Medicare fee schedule.

Remark code N67 indicates professional services aren't paid separately as they're included in a facility's payment under a demo project.

Remark code N670 indicates the service code is the primary procedure for Medicare's Multiple Procedure Payment Reduction rule.

Remark code N671 is an explanation for adjustments, indicating payment is aligned with the jurisdiction's cost-charge ratio.

Remark code N672 alerts that the specified amount has been applied to the Health Insurance Offset.

Remark code N673 indicates reimbursement is based on outpatient per diem, factor, or fee schedule amount, affecting payment calculations.

Remark code N674 is an alert that coverage is denied unless a specific prior procedure or service has been completed.

Remark code N675 indicates more details are needed from the injured party for claim processing.

Remark code N676 is an alert that a service is ineligible for payment under the Outpatient Facility Fee Schedule.

Remark code N677 is an alert indicating that submitted films/images will not be returned to the healthcare provider.

Remark code N678 is an alert indicating the absence of required post-operative images or visual field results in a claim submission.

Remark code N679 is an alert for healthcare providers about incomplete or invalid post-op images/visual field results.

Remark code N68 indicates a prior payment is reversed due to patient coverage by a demo project; contact the facility for payment.

Remark code N680 indicates an error due to missing, incomplete, or invalid dates of previous dental extractions.

Remark code N681 indicates a claim issue due to missing, incomplete, or invalid full arch series information.

Remark code N682 is an alert for missing or invalid prior periodontal therapy history in patient records.

Remark code N683 indicates a claim issue due to missing, incomplete, or invalid documentation of prior treatment.

Remark code N684 is an alert that payment was denied because a specialty claim was incorrectly submitted as a general claim.

Remark code N685 is an alert for missing or invalid prosthesis, crown, or inlay codes in healthcare billing submissions.

Remark code N686 is an alert indicating a questionnaire required for payment determination is missing, incomplete, or invalid.

Remark code N687 indicates a reversal of charges due to a patient's retroactive disenrollment from their insurance plan.

Remark code N688 is an alert indicating a reversal due to a medical or utilization review decision.

Remark code N689 is an alert indicating a payment reversal due to a retroactive adjustment in rates.

Remark code N69 indicates a PPS code was altered during claims processing, potentially affecting reimbursement.

Remark code N690 alerts healthcare providers that a reversal has occurred as a result of an appeal they submitted.

Remark code N691 is an alert indicating a reversal in billing due to an appeal submitted by the patient.

Remark code N692 alerts that a reversal occurred due to an incorrect rate in the initial claim adjudication process.

Remark code N693 indicates a claim reversal initiated by the provider's cancellation of the claim.

Remark code N694 is an alert indicating a claim reversal due to provider's resubmission or change to the original claim.

Remark code N695 alerts that a reversal occurred due to wrong patient financial responsibility info initially adjudicated.

Remark code N696 alerts healthcare providers of a reversal due to Coordination of Benefits or Third Party Liability retroactive adjustment.

Remark code N697 is an alert indicating a reversal due to adjustments from a payer's retroactive contract incentive program.

Remark code N698 is an alert indicating coverage loss due to unpaid health insurance premiums after the grace period ends.

Remark code N699 is an adjustment notice for payments affected by the Physician Quality Reporting System Incentive Program.

Remark code N7 indicates that the claim has been processed with consideration under Major Medical provisions.

Remark code N70 indicates that services are bundled for billing and payment under a single comprehensive charge.

Remark code N700 is an adjustment notice for payments based on compliance with the Electronic Health Records Incentive Program.

Remark code N701 is an adjustment notice indicating payment changes due to the Value-based Payment Modifier.

Remark code N702 is an alert indicating a decision was made based on review of past or ongoing claims for similar services.

Remark code N703 is an alert that the service billed conflicts with prior or pending claims, impacting payment.

Remark code N704 is a notification that appeals are not allowed, but corrected claim resubmission is possible if needed.

Remark code N705 indicates that a claim was denied due to incomplete or invalid documentation provided.

Remark code N706 indicates that a claim was denied due to missing documentation required for processing.

Remark code N707 indicates an issue with claims due to incomplete or invalid orders from healthcare providers.

Remark code N708 is an alert indicating that required orders are missing from the billing submission.

Remark code N709 indicates that the documentation or notes provided are incomplete or invalid for processing.

Remark code N71 indicates a processed unassigned claim for specific services was treated as assigned, as mandated by law. Providers must comply.

Remark code N710 is an alert indicating that payment or processing is delayed due to missing documentation or notes.

Remark code N711 is an alert indicating the summary provided is incomplete or invalid, requiring attention for claim processing.

Remark code N712 indicates a claim rejection due to the absence of a required summary document in the submission.

Remark code N713 indicates an insurance claim was denied due to an incomplete or invalid report submitted by the healthcare provider.

Remark code N714 is an alert indicating a required report is missing from the claim submission.

Remark code N715 is an alert indicating a claim's denial due to incomplete or invalid chart documentation.

Remark code N716 is an alert indicating a claim's processing delay due to the absence of the patient's medical chart.

Remark code N717 indicates invalid or missing documentation for a required face-to-face examination.

Remark code N718 indicates a claim denial due to missing documentation for a required face-to-face examination.

Remark code N719 indicates a penalty due to failure in meeting specific plan requirements.

Remark code N72 indicates a PPS code revision by medical reviewers due to lack of clinical record support.

Remark code N720 alerts healthcare providers that a patient has overpaid and may need a refund for the excess amount paid over their responsibility.

Remark code N721 indicates that coverage applies only if the service is part of a clinical trial.

Remark code N722 indicates that the patient needs to use Workers' Compensation Set-Aside funds for the medical service or item payment.

Remark code N723 is an alert that the patient must use Liability Set-Aside funds for the medical service or item payment.

Remark code N724 is an alert that payment should come from No-Fault set-aside funds for the specified medical service or item.

Remark code N725 indicates a liability insurer is responsible for ongoing medical services for the specified diagnosis.

Remark code N726 indicates a conditional payment is not permitted in the healthcare billing process.