| Code |
Current Narrative |
Medicare Initiated? |
| N348 |
You chose that this service/supply/drug would be rendered/supplies and billed by a different practitioner/supplier. |
Yes |
| N349 |
The administration method and drug must be reported to adjudicate this service. |
No |
| N350 |
Missing/incomplete/invalid description of service for a Not Otherwise Classified (NOC) code or an Unlisted procedure. |
No |
| N351 |
Service date outside of the approved treatment plan service dates. |
No |
| N352 |
There are no scheduled payments for this service. Submit a claim for each patient visit |
No |
| N353 |
Benefits have been estimated, when the actual services have been rendered, additional payment will be considered based on the submitted claim. |
No |
| N354 |
Incomplete/invalid invoice |
No |
| N355 |
The law permits exceptions to the refund requirement in two cases: – If you did not know, and could not have reasonably been expected to know, that we would not pay for this service; or – If you notified the patient in writing before providing the service that you believed that we were likely to deny the service, and the patient signed a statement agreeing to pay for the service. If you come within either exception, or if you believe the carrier was wrong in its determination that we do not pay for this service, you should request review of this determination within 30 days of the date of this notice. Your request for review should include any additional information necessary to support your position. If you request an appeal within 30 days of receiving this notice, you may delay refunding the amount to the patient until you receive the results of the review. If the review decision is favorable to you, you do not need to make any refund. If, however, the review is unfavorable, the law specifies that you must make the refund within 15 days of receiving the unfavorable review decision. The law also permits you to request an appeal at any time within 120 days of the date you receive this notice. However, an appeal request that is received more than 30 days after the date of this notice, does not permit you to delay making the refund. Regardless of when a review is requested, the patient will be notified that you have requested one, and will receive a copy of the determination. The patient has received a separate notice of this denial decision. The notice advises that he/she may be entitled to a refund of any amounts paid, if you should have known that we would not pay and did not tell him/her. It also instructs the patient to contact our office if he/she does not hear anything about a refund within 30 days. Note: (New Code 8/1/05) |
Yes |
