Remittance Advice Code N4 series

Remittance Advice Code List N4 list

N400 Alert: Electronically enabled providers should submit claims electronically.
Start: 08/01/2007
N401 Missing periodontal charting.
Start: 08/01/2007
N402 Incomplete/invalid periodontal charting.
Start: 08/01/2007
N403 Missing facility certification.
Start: 08/01/2007
N404 Incomplete/invalid facility certification.
Start: 08/01/2007
N405 This service is only covered when the donor's insurer(s) do not provide coverage for the service.
Start: 08/01/2007
N406 This service is only covered when the recipient's insurer(s) do not provide coverage for the service.
Start: 08/01/2007
N407 You are not an approved submitter for this transmission format.
Start: 08/01/2007
N408 This payer does not cover deductibles assessed by a previous payer.
Start: 08/01/2007
N409 This service is related to an accidental injury and is not covered unless provided within a specific time frame from the date of the accident.
Start: 08/01/2007
N410 Not covered unless the prescription changes.
Start: 08/01/2007 | Last Modified: 03/08/2011
Notes: (Modified 3/8/11)
N411 This service is allowed one time in a 6-month period.
Start: 08/01/2007 | Last Modified: 07/01/2016
Notes: (Modified 2/1/2009, Reactivated 7/1/2016)
N412 This service is allowed 2 times in a 12-month period.
Start: 08/01/2007 | Last Modified: 07/01/2016
Notes: (Modified 2/1/2009, Reactivated 7/1/2016)
N413 This service is allowed 2 times in a benefit year.
Start: 08/01/2007 | Last Modified: 07/01/2016
Notes: (Modified 2/1/2009, Reactivated 7/1/2016)
N414 This service is allowed 4 times in a 12-month period.
Start: 08/01/2007 | Last Modified: 07/01/2016
Notes: (Modified 2/1/2009, Reactivated 7/1/2016)
N415 This service is allowed 1 time in an 18-month period.
Start: 08/01/2007 | Last Modified: 07/01/2016
Notes: (Modified 2/1/2009, Reactivated 7/1/2016)
N416 This service is allowed 1 time in a 3-year period.
Start: 08/01/2007 | Last Modified: 07/01/2016
Notes: (Modified 2/1/2009, Reactivated 7/1/2016)
N417 This service is allowed 1 time in a 5-year period.
Start: 08/01/2007 | Last Modified: 07/01/2016
Notes: (Modified 2/1/2009, Reactivated 7/1/2016)
N418 Misrouted claim. See the payer's claim submission instructions.
Start: 08/01/2007
N419 Claim payment was the result of a payer's retroactive adjustment due to a retroactive rate change.
Start: 08/01/2007
N420 Claim payment was the result of a payer's retroactive adjustment due to a Coordination of Benefits or Third Party Liability Recovery.
Start: 08/01/2007
N421 Claim payment was the result of a payer's retroactive adjustment due to a review organization decision.
Start: 08/01/2007 | Last Modified: 05/08/2008
Notes: (Modified 2/29/08, typo fixed 5/8/08)
N422 Claim payment was the result of a payer's retroactive adjustment due to a payer's contract incentive program.
Start: 08/01/2007 | Last Modified: 05/08/2008
Notes: (Typo fixed 5/8/08)
N423 Claim payment was the result of a payer's retroactive adjustment due to a non standard program.
Start: 08/01/2007
N424 Patient does not reside in the geographic area required for this type of payment.
Start: 08/01/2007
N425 Statutorily excluded service(s).
Start: 08/01/2007
N426 No coverage when self-administered.
Start: 08/01/2007
N427 Payment for eyeglasses or contact lenses can be made only after cataract surgery.
Start: 08/01/2007
N428 Not covered when performed in this place of service.
Start: 08/01/2007 | Last Modified: 03/08/2011
Notes: (Modified 3/8/11)
N429 Not covered when considered routine.
Start: 08/01/2007 | Last Modified: 03/08/2011
Notes: (Modified 3/8/11)
N430 Procedure code is inconsistent with the units billed.
Start: 11/05/2007
N431 Not covered with this procedure.
Start: 11/05/2007 | Last Modified: 03/08/2011
Notes: (Modified 3/8/11)
N432 Alert: Adjustment based on a Recovery Audit.
Start: 11/05/2007 | Last Modified: 07/01/2015
Notes: (Modified 7/1/15)
N433 Resubmit this claim using only your National Provider Identifier (NPI).
Start: 02/29/2008 | Last Modified: 03/14/2014
Notes: (Modified 3/14/2014)
N434 Missing/Incomplete/Invalid Present on Admission indicator.
Start: 07/01/2008
N435 Exceeds number/frequency approved /allowed within time period without support documentation.
Start: 07/01/2008
N436 The injury claim has not been accepted and a mandatory medical reimbursement has been made.
Start: 07/01/2008
N437 Alert: If the injury claim is accepted, these charges will be reconsidered.
Start: 07/01/2008
N438 This jurisdiction only accepts paper claims.
Start: 07/01/2008 | Last Modified: 03/14/2014
Notes: (Modified 3/14/2014)
N439 Missing anesthesia physical status report/indicators.
Start: 07/01/2008
N440 Incomplete/invalid anesthesia physical status report/indicators.
Start: 07/01/2008
N441 This missed/cancelled appointment is not covered.
Start: 07/01/2008 | Last Modified: 07/15/2013
Notes: (Modified 7/15/2013)
N442 Payment based on an alternate fee schedule.
Start: 07/01/2008
N443 Missing/incomplete/invalid total time or begin/end time.
Start: 07/01/2008
N444 Alert: This facility has not filed the Election for High Cost Outlier form with the Division of Workers' Compensation.
Start: 07/01/2008
N445 Missing document for actual cost or paid amount.
Start: 07/01/2008
N446 Incomplete/invalid document for actual cost or paid amount.
Start: 07/01/2008
N447 Payment is based on a generic equivalent as required documentation was not provided.
Start: 07/01/2008
N448 This drug/service/supply is not included in the fee schedule or contracted/legislated fee arrangement.
Start: 07/01/2008 | Last Modified: 03/14/2014
Notes: (Modified 3/14/2014)
N449 Payment based on a comparable drug/service/supply.
Start: 07/01/2008
N450 Covered only when performed by the primary treating physician or the designee.
Start: 07/01/2008
N451 Missing Admission Summary Report.
Start: 07/01/2008
N452 Incomplete/invalid Admission Summary Report.
Start: 07/01/2008
N453 Missing Consultation Report.
Start: 07/01/2008
N454 Incomplete/invalid Consultation Report.
Start: 07/01/2008
N455 Missing Physician Order.
Start: 07/01/2008
N456 Incomplete/invalid Physician Order.
Start: 07/01/2008
N457 Missing Diagnostic Report.
Start: 07/01/2008
N458 Incomplete/invalid Diagnostic Report.
Start: 07/01/2008
N459 Missing Discharge Summary.
Start: 07/01/2008
N460 Incomplete/invalid Discharge Summary.
Start: 07/01/2008
N461 Missing Nursing Notes.
Start: 07/01/2008
N462 Incomplete/invalid Nursing Notes.
Start: 07/01/2008
N463 Missing support data for claim.
Start: 07/01/2008
N464 Incomplete/invalid support data for claim.
Start: 07/01/2008
N465 Missing Physical Therapy Notes/Report.
Start: 07/01/2008
N466 Incomplete/invalid Physical Therapy Notes/Report.
Start: 07/01/2008
N467 Missing Tests and Analysis Report.
Start: 07/01/2008 | Last Modified: 03/14/2014
Notes: (Modified 3/14/2014)
N468 Incomplete/invalid Report of Tests and Analysis Report.
Start: 07/01/2008
N469 Alert: Claim/Service(s) subject to appeal process, see section 935 of Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA).
Start: 07/01/2008
N470 This payment will complete the mandatory medical reimbursement limit.
Start: 07/01/2008
N471 Missing/incomplete/invalid HIPPS Rate Code.
Start: 07/01/2008
N472 Payment for this service has been issued to another provider.
Start: 07/01/2008
N473 Missing certification.
Start: 07/01/2008
N474 Incomplete/invalid certification.
Start: 07/01/2008 | Last Modified: 03/14/2014
Notes: (Modified 3/14/2014)
N475 Missing completed referral form.
Start: 07/01/2008
N476 Incomplete/invalid completed referral form.
Start: 07/01/2008 | Last Modified: 03/14/2014
Notes: (Modified 3/14/2014)
N477 Missing Dental Models.
Start: 07/01/2008
N478 Incomplete/invalid Dental Models.
Start: 07/01/2008 | Last Modified: 03/14/2014
Notes: (Modified 3/14/2014)
N479 Missing Explanation of Benefits (Coordination of Benefits or Medicare Secondary Payer).
Start: 07/01/2008
N480 Incomplete/invalid Explanation of Benefits (Coordination of Benefits or Medicare Secondary Payer).
Start: 07/01/2008
N481 Missing Models.
Start: 07/01/2008
N482 Incomplete/invalid Models.
Start: 07/01/2008 | Last Modified: 03/14/2014
Notes: (Modified 3/14/2014)
N483 Missing Periodontal Charts.
Start: 07/01/2008 | Stop: 05/01/2015 | Last Modified: 11/01/2014
Notes: (Modified 11/1/2014)
N484 Incomplete/invalid Periodontal Charts.
Start: 07/01/2008 | Stop: 05/01/2015 | Last Modified: 11/01/2014
Notes: (Modified 3/14/2014, 11/1/2014)
N485 Missing Physical Therapy Certification.
Start: 07/01/2008
N486 Incomplete/invalid Physical Therapy Certification.
Start: 07/01/2008
N487 Missing Prosthetics or Orthotics Certification.
Start: 07/01/2008
N488 Incomplete/invalid Prosthetics or Orthotics Certification.
Start: 07/01/2008 | Last Modified: 03/14/2014
Notes: (Modified 3/14/2014)
N489 Missing referral form.
Start: 07/01/2008
N490 Incomplete/invalid referral form.
Start: 07/01/2008 | Last Modified: 03/14/2014
Notes: (Modified 3/14/2014)
N491 Missing/Incomplete/Invalid Exclusionary Rider Condition.
Start: 07/01/2008
N492 Alert: A network provider may bill the member for this service if the member requested the service and agreed in writing, prior to receiving the service, to be financially responsible for the billed charge.
Start: 07/01/2008
N493 Missing Doctor First Report of Injury.
Start: 07/01/2008
N494 Incomplete/invalid Doctor First Report of Injury.
Start: 07/01/2008
N495 Missing Supplemental Medical Report.
Start: 07/01/2008
N496 Incomplete/invalid Supplemental Medical Report.
Start: 07/01/2008
N497 Missing Medical Permanent Impairment or Disability Report.
Start: 07/01/2008
N498 Incomplete/invalid Medical Permanent Impairment or Disability Report.
Start: 07/01/2008
N499 Missing Medical Legal Report.
Start: 07/01/2008