Remark code N118 indicates that reimbursement for the service in question is not provided if the service is billed more than once within a 28-day period. This means that if a healthcare provider submits a claim for this particular service and it has already been billed within the last 28 days, the claim will be denied based on the frequency of submission. Providers should ensure that billing intervals comply with this limitation to avoid claim denials associated with this remark code.
Common causes of code N118 are:
1. Submitting claims for the same service for the same patient more frequently than the 28-day billing cycle allows.
2. Incorrectly billing multiple sessions or units of a service that should be consolidated into a single claim for a 28-day period.
3. Failing to track the initial date of service accurately, leading to premature rebilling within the 28-day window.
4. Overlooking payer-specific guidelines that stipulate the minimum duration between services.
5. System errors in the practice management software that may duplicate claims or fail to recognize the 28-day billing restriction.
6. Misinterpretation of the 28-day rule, such as misunderstanding the start and end dates or the types of services subject to this limitation.
Ways to mitigate code N118 include implementing a robust tracking system that monitors the frequency of service claims to ensure they are not submitted more than once within a 28-day period. Staff training on proper billing cycles and intervals for specific services can also help prevent this issue. Additionally, using advanced scheduling software that alerts billers when a service is being scheduled or billed too soon can be effective. Regular audits of billing practices can also identify patterns that may lead to this code being triggered, allowing for corrective action before claims are submitted.
The steps to address code N118 involve first reviewing the patient's billing history to confirm if the service in question was indeed billed more than once within a 28-day period. If the service was incorrectly billed multiple times, submit a corrected claim with the appropriate service date. If the service was correctly billed, check for any errors in the date of service or billing codes that might have triggered the remark code erroneously. In cases where the service was medically necessary more frequently than the standard 28-day cycle, ensure that proper documentation and any required authorization supporting medical necessity are on file, and consider submitting an appeal with this supporting documentation. Additionally, review your practice's scheduling and billing procedures to prevent future occurrences of this issue.