Updates: Remittance Advice Remark Code & Claim Remark Code
November 1, 2004The Remittance Advice Remark Codes are maintained by CMS and updated three times per year. The June 2004 updates for the X12N 835 Health Care Remittance Advice Remark Codes and the X12N835 Health Care Claim Adjustment have been posted and are available on line at: https://www.wpc-edi.com/codes/Codes.asp
The new codes will become effective on January 01, 2005. The following codes have been added:
| Code | Description |
| N217 | We pay only one site of service per provider per claim |
| N218 | You must furnish and service this item for as long as the patient continues to need it. We can pay for maintenance and/or servicing for the time period specified in the contract or coverage manual |
| N219 | Payment based on previous payer’s allowed amount |
| N220 | See the payer’s web site or contact the payer’s Customer Service department to obtain forms and instructions for filing a provider dispute |
| N221 | Missing Admitting History and Physical report |
| N222 | Incomplete/invalid Admitting History and Physical report |
| N223 | Missing documentation of benefit to the patient during initial treatment period |
| N224 | Incomplete/invalid documentation of benefit to the patient during initial treatment period |
| N225 | Incomplete/invalid documentation/orders/ notes/ summary/ report/ invoice |
| N226 | Incomplete/invalid American Diabetes Association Certificate of Recognition |
| N227 | Incomplete/invalid Certificate of Medical Necessity |
| N228 | Incomplete/invalid consent form |
| N229 | Incomplete/invalid contract indicator |
| N230 | Incomplete/invalid indication of whether the patient owns the equipment that requires the part or supply |
| N231 | Incomplete/invalid invoice or statement certifying the actual cost of the lens, less discounts, and/or the type of intraocular lens used |
| N232 | Incomplete/invalid itemized bill |
| N233 | Incomplete/invalid operative report |
| N234 | Incomplete/invalid oxygen certification/re-certification |
| N235 | Incomplete/invalid pacemaker registration form |
| N236 | Incomplete/invalid pathology report |
| N237 | Incomplete/invalid patient medical record for this service |
| N238 | Incomplete/invalid physician certified plan of care |
| N239 | Incomplete/invalid physician financial relationship form |
| N240 | Incomplete/invalid radiology report |
| N241 | Incomplete/invalid Review Organization Approval |
| N242 | Incomplete/invalid x-ray |
| N243 | Incomplete/invalid/not approved screening document |
| N244 | Incomplete/invalid pre-operative photos/visual field results |
| N245 | Incomplete/invalid plan information for other insurance |
| N3 | Missing consent form |
| MA92 | Missing plan information for other insurance |
| M29 | Missing operative report |
| M30 | Missing radiology report |
| M31 | Missing radiology report |