Denial code N816

Remark code N354 indicates an issue with a claim due to an incomplete or invalid invoice, requiring correction for processing.

Remark code N355 is an alert indicating exceptions to refund requirements under specific conditions related to service payment denials.

Remark code N356 is an alert that a service isn't covered if done with or after a non-covered procedure.

Remark code N357 indicates that the necessary time gap between related healthcare services or supplies was not adhered to.

Remark code N358 alerts healthcare providers that a decision may be reconsidered with submission of further documentation as specified.

Remark code N359 is an alert indicating the patient's height information is missing, incomplete, or invalid in the claim.

Remark code N36 indicates that a claim must comply with the primary insurer's rules before secondary payment consideration.

Remark code N360 is an alert indicating benefits were estimated without coordination of benefits. Submit primary payer info with the secondary claim.

Remark code N362 indicates that the submitted days or units of service surpass the maximum allowed by the payer.

Remark code N363 alerts healthcare providers about upcoming policy/procedure changes that may impact claim determinations.

Remark code N364 indicates that, per the agreement, deductible and/or coinsurance amounts must be waived by the provider.

Remark code N366 is a notice that a claim was denied due to missing information, but can be reopened if the required details are submitted within one year.

Remark code N367 indicates a claim has been sent to a Consumer Spending Account processor, such as an FSA or HSA, for review.

Remark code N368 is an instruction for providers to appeal a decision on a previously adjudicated claim for resolution.

Remark code N369 indicates a processed claim is deficient as per state legislation/regulation, requiring further action.

Remark code N37 indicates a claim issue due to a missing, incomplete, or invalid tooth number or letter on dental claims.

Remark code N370 indicates billing surpasses the rental months authorized by the insurance, requiring review or adjustment.

Remark code N371 indicates that the equipment's ownership must be transferred to the patient.

Remark code N372 indicates that only charges deemed reasonable and necessary for maintenance or service are covered by insurance.

Remark code N373 indicates a refund to the payer who incorrectly paid services as primary, due to another payer being identified as primary.

Remark code N374 indicates Medicare Part A benefits are depleted; a Part B Remittance Advice is now necessary for processing.

Remark code N375 indicates a claim issue due to missing or invalid information needed to verify dependent eligibility.

Remark code N376 indicates when a patient is on active military duty, making TRICARE the primary insurance coverage.

Remark code N377 indicates payment adjustments were made based on a processed replacement claim.

Remark code N378 indicates a claim issue due to a missing, incomplete, or invalid prescription quantity on the submission.

Remark code N379 indicates a discrepancy between claim and line level information, requiring review for accurate processing.

Remark code N380 indicates the original claim was processed; providers should submit a corrected claim for further review.

Remark code N381 is an alert to review contractual agreements for specific billing and payment rules related to charges.

Remark code N382 is an alert for missing or incorrect patient ID details in healthcare billing documents.

Remark code N383 is an explanation for services not covered due to being considered cosmetic by the insurer.

Remark code N384 is an alert that the claimed service for a previously removed body part/tooth cannot be processed.

Remark code N385 indicates a claim issue due to untimely admission notification as per the plan's procedures.

Remark code N386 indicates a decision based on a National Coverage Determination (NCD), outlining coverage for specific services or items.

Remark code N387 is a notification to submit the claim to the patient's secondary insurer for possible supplemental benefits payment.

Remark code N388 indicates a claim issue due to a missing, incomplete, or invalid prescription number.

Remark code N389 is an alert indicating a duplicate prescription number has been submitted in a claim.

Remark code N39 indicates an issue with billing where the dental procedure code does not match the specified tooth number/letter.

Remark code N390 indicates that the service or report provided cannot be billed as a separate charge.

Remark code N391 indicates a claim denial due to missing emergency department records, requiring submission for processing.

Remark code N392 is an alert indicating that emergency department records are incomplete or invalid, requiring attention.

Remark code N393 indicates a claim denial due to the absence of required progress notes or reports.

Remark code N394 is an alert indicating the submission of incomplete or invalid progress notes or reports in billing.

Remark code N395 is an alert indicating a claim's denial due to the absence of the required laboratory report.

Remark code N396 is an alert indicating an incomplete or invalid lab report, requiring review for accurate healthcare billing.

Remark code N397 indicates benefits are denied for services/items not fully provided or delivered.

Remark code N398 is an alert indicating a claim's denial due to a missing elective consent form, requiring action.

Remark code N399 indicates an issue with the elective consent form, either due to it being incomplete or invalid.

Remark code N4 indicates an EOB from prior insurance is missing, incomplete, or invalid, requiring action for claim processing.

Remark code N40 indicates a claim denial due to missing radiology films or images required for processing.

Remark code N400 indicates that providers capable of electronic submissions should file claims digitally for efficiency.

Remark code N401 is an alert indicating the absence of required periodontal charting in a claim submission.

Remark code N402 is an alert for healthcare providers about incomplete or invalid periodontal charting in billing documents.

Remark code N403 indicates a claim was denied due to the absence of necessary facility certification documentation.

Remark code N404 is an alert indicating the facility's certification is either incomplete or invalid, requiring attention.

Remark code N405 is an explanation that a service is covered only if the donor's insurers do not cover it.

Remark code N406 indicates a service is covered only if the recipient's insurers do not offer coverage for this specific service.

Remark code N407 indicates that the sender is not authorized to submit claims in the specified transmission format.

Remark code N408 is an explanation that the current insurer does not cover deductibles charged by another payer.

Remark code N409 indicates a service linked to an accidental injury is not covered unless it's within a certain time from the accident date.

Remark code N410 is an indication that a service is not covered unless there is a change in the prescription.

Remark code N411 indicates a service is permitted once every 6 months, highlighting claim limitations for healthcare providers.

Remark code N412 indicates a limit of 2 allowances for this service within a 12-month period, guiding billing adjustments.

Remark code N413 is an alert indicating a service is covered twice in a benefit year, guiding billing adjustments.

Remark code N414 indicates a limit of 4 allowances for this service within a 12-month period, guiding billing adjustments.

Remark code N415 indicates a limitation: the service is permitted only once within an 18-month timeframe.

Remark code N416 indicates a limitation: the service is permitted only once every three years.

Remark code N417 is an alert that a service is approved only once every 5 years, indicating billing limitations.

Remark code N418 is an alert that a claim was sent incorrectly. Review the payer's submission guidelines for proper routing.

Remark code N419 is an explanation for claim adjustments due to payer's retroactive rate changes.

Remark code N42 indicates a claim denial due to a missing mental health assessment in the documentation.

Remark code N420 indicates a claim payment adjustment due to a retroactive Coordination of Benefits or Third Party Liability Recovery.

Remark code N421 indicates a claim payment adjustment following a payer's review organization decision for retroactive changes.

Remark code N422 indicates a claim payment adjustment due to a retroactive change from a payer's contract incentive program.

Remark code N423 indicates a claim payment adjustment by the payer, due to a retroactive change from a non-standard program.

Remark code N424 indicates a payment denial because the patient's residence is outside the required geographic area.

Remark code N425 indicates a service is not covered by insurance as it's legally excluded from coverage.

Remark code N426 is an explanation for denied insurance claims due to self-administered medication lacking coverage.

Remark code N427 indicates payment for eyeglasses or contact lenses is approved only post-cataract surgery.

Remark code N428 is an explanation for services not covered at the specified location.

Remark code N429 is an indicator that a service is not covered by insurance when it is deemed routine.

Remark code N43 indicates that the patient's allotted bed hold or leave days have been surpassed in a healthcare facility.

Remark code N430 indicates that the procedure code does not match the number of units billed, suggesting a billing error.

Remark code N431 indicates a service isn't covered when paired with the specific procedure performed.

Remark code N432 is an alert indicating an adjustment made due to a Recovery Audit finding in healthcare billing.

Remark code N433 is a notification to resubmit a claim with the provider's exclusive National Provider Identifier (NPI) only.

Remark code N434 is an alert for missing or invalid Present on Admission indicators in healthcare claims documentation.

Remark code N435 is an alert that claims exceed the approved number/frequency within a time period without proper documentation.

Remark code N436 indicates that the injury claim is pending acceptance, yet a compulsory medical payment has been processed.

Remark code N437 indicates that if the injury claim is accepted, the charges in question will be reconsidered for payment.

Remark code N438 is an alert that only paper claims are accepted in this specific jurisdiction, impacting claim processing.

Remark code N439 is an alert indicating the absence of required anesthesia physical status report/indicators in a claim.

Remark code N440 is an alert for healthcare providers about incomplete or invalid anesthesia status reports.

Remark code N441 indicates that the insurance does not cover missed or cancelled appointments.

Remark code N442 is an indication that payment was adjusted according to an alternative fee schedule.

Remark code N443 is an alert for missing or incorrect total time or session start/end times on a claim submission.

Remark code N444 is an alert indicating a facility hasn't filed the Election for High Cost Outlier form with the Division of Workers' Compensation.

Remark code N445 indicates a claim denial due to missing documentation for the actual cost or paid amount.

Remark code N446 is an alert indicating missing or incorrect documentation for the actual cost or payment amount.

Remark code N447 indicates payment adjustment due to lack of required documentation for brand-name medication, opting for a generic equivalent.

Remark code N448 indicates a drug, service, or supply not covered under the fee schedule or contracted fee arrangements.