Remark code N15 indicates that services provided to a newborn should be billed as distinct transactions and not grouped with other services. This ensures proper accounting and reimbursement for the specific care given to the newborn.
Common causes of code N15 are:
1. The billing of newborn services was incorrectly included with the mother's charges.
2. The claim was submitted without a separate identifier for the newborn, such as a distinct patient ID or date of birth.
3. The services provided to the newborn were not itemized as individual line items on the claim form.
4. The incorrect use of billing codes that do not specify that the services were for a newborn.
5. Failure to follow payer-specific guidelines for billing newborn services separately from the mother's claim.
6. The use of a global billing code that encompasses the mother's and newborn's services together, rather than individual codes for each.
7. Lack of communication between the delivering provider, pediatric care team, and the billing department, leading to combined charges.
8. Inadequate documentation to support the separation of services between the mother and the newborn.
Ways to mitigate code N15 include ensuring that all services provided to a newborn are billed under the newborn's unique patient identifier or medical record number, rather than under the mother's. This involves creating a separate account for the newborn immediately after birth and accurately documenting all services, procedures, and supplies provided to the infant. It's also important to verify the correct use of diagnosis codes that reflect the newborn's conditions or treatments, and to double-check that the billing staff is aware of the payer's guidelines for newborn billing to avoid bundling services with the mother's account. Regular training for coding and billing personnel on the nuances of neonatal care billing can help prevent this code from appearing on remittance advice.
The steps to address code N15 involve ensuring that all services provided to a newborn are billed on a separate claim from the mother's services. This requires a review of the billing process to confirm that the newborn's charges are not included on the mother's bill. If they are, the charges should be removed and a new claim should be created specifically for the newborn, using their own unique patient identifier. It's important to verify that all the newborn's services are accurately documented and coded, and that the claim includes all necessary information, such as the date of birth, to substantiate the services as separate from the mother's. Once the new claim is prepared, it should be submitted promptly to the payer for processing. If the claim for the newborn has already been submitted incorrectly, a corrected claim must be filed. Additionally, staff should be trained or reminded of the correct billing procedures for newborn services to prevent future occurrences of this issue.