Remark code N795 indicates an item must be reprocessed as a purchase for proper billing and reimbursement.
Remark code N795 indicates that the item must be resubmitted as a purchase.
Common causes of code N795 are incorrect billing for items that should be classified as purchases rather than rentals, failure to specify the item as a purchase on the initial claim submission, or the need to provide additional documentation to justify the item as a purchase rather than a rental.
Ways to mitigate code N795 include ensuring that the billing team accurately distinguishes between items that should be billed as rentals versus those that need to be billed as purchases from the outset. This involves training staff to recognize the specific criteria that qualify an item for purchase rather than rental, based on the nature of the item and its intended use duration. Implementing a pre-billing checklist that includes a verification step for the rental versus purchase status of items can also help. Additionally, establishing a direct line of communication with suppliers to confirm the status of items before billing can prevent this issue. Regular audits of billing practices related to rentals and purchases can identify patterns that lead to errors and allow for corrective action before claims are submitted.
The steps to address code N795 involve first reviewing the original claim to identify the item or service that was incorrectly submitted for rental or another billing category when it should have been submitted as a purchase. Next, gather all necessary documentation that supports the item's eligibility for purchase, including any medical necessity documentation, prescriptions, or physician orders that specify the item as a purchase. Then, correct the billing on the claim to reflect the item as a purchase, ensuring that all other claim details are accurate and complete. Finally, resubmit the corrected claim to the payer, and monitor the claim's status to ensure it is processed and paid appropriately. If the claim is denied again or if there are further issues, be prepared to provide additional documentation or clarification as requested by the payer.
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