Denial code N859

Remark code N727 indicates a no-fault insurer is responsible for ongoing medical services for the specified diagnosis.

Remark code N728 indicates a workers' comp insurer is responsible for ongoing medical services for the specified diagnosis.

Remark code N729 is an alert indicating the absence of the patient's medical or dental record for a specific service.

Remark code N730 indicates an issue with the patient's medical/dental record being incomplete or invalid for the service provided.

Remark code N731 is an alert indicating an incomplete or invalid mental health assessment in healthcare billing.

Remark code N732 indicates that services at unlicensed facilities are not covered for reimbursement.

Remark code N733 is an indication that regulatory surcharges should be paid directly to the state by healthcare providers.

Remark code N734 indicates eligibility for medical services is based on inability to work or perform normal activities due to illness or injury.

Remark code N736 is an alert indicating the Sleep Study Report submitted is incomplete or invalid for processing.

Remark code N737 is an alert indicating a claim was denied due to the absence of a required sleep study report.

Remark code N738 is an alert indicating the Vein Study Report submitted is incomplete or invalid, requiring review or correction.

Remark code N739 is an alert indicating a claim's denial due to the absence of the required vein study report.

Remark code N74 indicates a need to resubmit separate claims for services given in distinct calendar months.

Remark code N740 indicates insufficient funds in a member's Consumer Spending Account to cover their liability for a specific claim or service.

Remark code N741 indicates a payment adjustment due to site-neutral policy, affecting reimbursement rates.

Remark code N743 is an adjustment notice indicating services might be linked to a work-related accident.

Remark code N744 is an adjustment notice indicating services might be linked to an auto or other accident, affecting coverage.

Remark code N745 is an alert indicating the absence of required ambulance report documentation in a claim submission.

Remark code N746 is an alert for healthcare providers about an incomplete or invalid Ambulance Report in billing submissions.

Remark code N747 indicates a misdirected claim/service. Providers should submit the claim to the payer/plan where the patient resides.

Remark code N748 is an adjustment notice indicating the absence of related hospital charge submissions.

Remark code N749 is an alert indicating a claim's denial due to the absence of a required blood gas report.

Remark code N75 indicates a claim denial due to missing or invalid tooth surface information for dental billing.

Remark code N750 is an alert indicating the Blood Gas Report submitted is incomplete or invalid, requiring review or correction.

Remark code N751 is an adjustment notice indicating coverage under a Medicare Part D plan, affecting claim processing.

Remark code N752 is an alert for missing or invalid HIPPS Treatment Authorization Code, indicating a need for correct submission.

Remark code N753 is an alert for missing, incomplete, or invalid Attachment Control Numbers in healthcare billing documents.

Remark code N754 is an alert for missing or invalid Referring Provider details on the 1500 Claim Form, requiring correction.

Remark code N755 is an alert for missing, incomplete, or invalid ICD Indicator in healthcare billing documents.

Remark code N756 is an alert for missing or incorrect drop-off address details in healthcare billing submissions.

Remark code N757 is an adjustment notice for healthcare providers, indicating billing aligned with the Federal Indian Fees schedule.

Remark code N758 is an adjustment notice indicating a decision based on prior authorization for healthcare providers.

Remark code N759 is an adjustment to payment based on compliance with NEMA Standard XR-29-2013 for imaging efficiency.

Remark code N76 indicates an issue with the claim due to missing, incomplete, or invalid number of riders.

Remark code N760 indicates that the facility is not authorized to receive payment for the provided services.

Remark code N761 indicates that the provider lacks authorization to receive payment for the specified service(s).

Remark code N762 indicates that the facility lacks certification for Tomosynthesis (3-D) mammography services.

Remark code N763 is a notification that the demonstration code used is incorrect for the claim and advises resubmission without it.

Remark code N764 is an alert for missing or invalid Hematocrit (HCT) values in healthcare claims documentation.

Remark code N765 is an explanation that the payer does not cover coinsurance charged by another insurer.

Remark code N766 is an explanation that the payer does not cover co-payments assessed by another insurer.

Remark code N767 indicates a claim won't be processed until the provider enrolls in the Medicaid program of the member's state.

Remark code N768 indicates an incomplete or invalid initial evaluation report in healthcare billing.

Remark code N769 indicates a claim needs a specific lateral diagnosis to be processed correctly.

Remark code N77 indicates a claim issue due to a missing, incomplete, or invalid designated provider number.

Remark code N770 indicates that the provider's adjustment request has been processed, leading to an adjustment of the original claim.

Remark code N771 alerts healthcare providers that charging beyond the federal limiting charge amount is prohibited by law.

Remark code N772 indicates to rebill urgent/emergent and ancillary services separately for correct processing.

Remark code N773 indicates that the drug was not purchased from a designated specialty vendor, impacting claim processing.

Remark code N774 is a notification to check your Third Party Processor Agreement for fees related to this payment type.

Remark code N775 is an adjustment notice indicating payment changes due to x-ray radiograph being on film.

Remark code N776 indicates that the service provided is not eligible for Telehealth coverage under the patient's plan.

Remark code N777 is an alert indicating the Assignment of Benefits Indicator is missing from a claim submission.

Remark code N778 is an alert indicating the absence of primary care physician details in a claim submission.

Remark code N779 is a notification that replacement or void claims must wait until the initial claim's final decision before resubmission.

Remark code N78 indicates that a claim was denied because the EPSDT checkup for a child or teen lacks required components.

Remark code N780 is an alert for a missing, incomplete, or invalid end therapy date in healthcare claims.

Remark code N781 alerts providers that the patient is a Medicaid/Medicare Beneficiary, advising a review of records for any incorrect deductible collections.

Remark code N782 is an alert that the patient is a Medicaid/Medicare Beneficiary, advising to check records for incorrect coinsurance charges.

Remark code N783 is a notification that the patient is on Medicaid/Medicare, advising to check for incorrect copays that might be billed elsewhere.

Remark code N784 is an alert indicating a claim lacks the required comprehensive procedure code for processing.

Remark code N785 is an alert indicating the absence of current radiology films or images required for claim processing.

Remark code N786 is an explanation for limited benefits during orthodontic treatment phases.

Remark code N787 alerts that PHP patients must receive a minimum of 20 hours weekly as per 42 CFR 410.43, following the care plan.

Remark code N788 is an alert indicating the third-party administrator or review organization lacks necessary information.

Remark code N789 indicates that services related to clinical trials are not included in the patient's insurance coverage benefits.

Remark code N79 indicates a billing error where the service provided doesn't match the patient's location details.

Remark code N790 indicates a provider or supplier lacks accreditation for the specific product or service billed.

Remark code N791 is an alert indicating a claim was denied due to the absence of a required history and physical report.

Remark code N792 is an alert indicating the history & physical report submitted is incomplete or invalid, requiring review.

Remark code N794 is an adjustment notice indicating payment changes due to the technology type utilized in treatment.

Remark code N795 indicates an item must be reprocessed as a purchase for proper billing and reimbursement.

Remark code N796 is an alert for healthcare providers about missing or invalid Hemoglobin values in documentation.

Remark code N797 indicates an error due to a missing, incomplete, or invalid date qualifier in a claim submission.

Remark code N798 is a notification to void the original claim and submit a new one for accurate processing.

Remark code N799 indicates that a claim's submitted identifier must be specific to an individual, not a group, for processing.

Remark code N8 indicates a crossover claim was denied by a previous payer due to incomplete data. Resubmit the claim with full details for proper adjudication.

Remark code N80 indicates a claim issue due to missing, incomplete, or invalid prenatal screening information.

Remark code N800 is an alert that claims must contain only one service date, ensuring accurate billing and processing.

Remark code N801 is an indication that services were provided in a facility under a self-insured tribal Group Health Plan as per 42 CFR 136.

Remark code N802 is an alert that the claim isn't payable in the current service area and must be filed to the correct Payer/Plan.

Remark code N803 indicates that the claim should be submitted by the Contracted Medical Group or Hospital, not the individual provider.

Remark code N804 indicates the claim/service underwent processing via the Outpatient Code Editor (OCE) for evaluation.

Remark code N805 indicates the claim/service was reviewed for accuracy and processed using the Correct Code Editor (CCE).

Remark code N806 is an explanation that payment is part of the overall transplant allowance.

Remark code N807 is a payment adjustment notification related to the Merit-based Incentive Payment System (MIPS).

Remark code N808 indicates services not covered due to provider type/specialty. Essential for healthcare billing and claims adjustments.

Remark code N809 is an adjustment notice for services priced based on prior competitive bidding, advising to consult the local contractor for details.

Remark code N81 indicates an incompatibility between the billed procedure and the tooth surface code on a dental claim.

Remark code N810 indicates a claim processed at in-network benefits due to a disaster declaration, with standard network rules reinstating post-declaration.

Remark code N811 is an alert indicating the absence of Federal Sequestration Reduction details from a previous insurer's payment.

Remark code N812 indicates that service dates must not exceed an 18-month span between start and end dates.

Remark code N815 is an alert for a claim issue due to a missing, incomplete, or invalid National Drug Code unit count.

Remark code N816 is an alert for missing or invalid National Drug Code (NDC) unit of measure in billing documents.

Remark code N817 is a notification for labs to collect & report private payor data to CMS from Jan 1 - Mar 31, 2020.

Remark code N818 indicates that the dates of service on a claim don't align with the Electronic Visit Verification System data.

Remark code N819 is an alert indicating the patient isn't enrolled in the Electronic Visit Verification System.

Remark code N82 indicates that providers must accept insurance payment as full settlement if their contract with a third party payer requires it.

Remark code N820 indicates that the units submitted via Electronic Visit Verification don't meet the visit's required standards.

Remark code N821 is an alert indicating a visit was not recorded in the Electronic Visit Verification System.