Remark code N622 is an explanation for services not covered due to the date of the injury or accident.
Remark code N622 indicates that the service or item billed is not covered due to it being related to an injury or accident that occurred on a date not covered by the patient's current insurance policy or benefit period.
Common causes of code N622 are incorrect or missing accident date information on the claim, services provided outside the coverage period for accident-related injuries, and failure to submit necessary documentation verifying the date of the accident or injury.
Ways to mitigate code N622 include ensuring accurate and timely documentation of the patient's injury or accident date in all relevant medical records and billing submissions. It's crucial to verify the patient's coverage effective dates with their insurance provider before rendering services. Implementing a pre-authorization process for treatments related to injuries or accidents can also help identify coverage issues in advance. Regular training for staff on the importance of precise data entry and the verification of insurance details can further prevent this code from occurring. Additionally, developing a system to cross-check the dates of service against the injury or accident date reported can catch discrepancies before claims are submitted.
The steps to address code N622 involve a multi-faceted approach to ensure accurate processing and reimbursement. Initially, verify the date of injury or accident reported on the claim against the patient's medical records and any documentation provided at the time of service. If a discrepancy is found, correct the date on the claim and resubmit it with the accurate information. In cases where the date is accurate but the claim was denied, gather and submit any additional documentation that supports the medical necessity of the services provided for the specific date of injury or accident. This may include physician notes, diagnostic reports, or a letter of explanation detailing the connection between the services rendered and the injury or accident. If the denial is upheld upon appeal, review the patient's coverage to identify if an alternative billing route is available, such as submitting the claim to a different insurance policy the patient may have. Throughout this process, maintain clear and open communication with the patient regarding the status of their claim and any potential financial responsibility they may have.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
