Denial code N153

Remark code N153 indicates an issue with the claim due to missing, incomplete, or invalid room and board rate details.

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What is Denial Code N153

Remark code N153 indicates that the claim submitted lacks a valid room and board rate, or the information provided is incomplete or incorrect. This code alerts the provider that in order to process the claim, additional details regarding the charges for the patient's room and board need to be provided or corrected.

Common Causes of RARC N153

Common causes of code N153 are incorrect entry of the room and board charges on the claim form, failure to specify the type of room (such as private or semi-private), omission of the rate per day or per service, use of outdated or incorrect billing codes for room and board services, and lack of proper documentation to support the room and board charges submitted. Additionally, discrepancies between the charged rate and the contracted rate with the payer can also trigger this remark code.

Ways to Mitigate Denial Code N153

Ways to mitigate code N153 include ensuring that all claims submitted include the correct and complete room and board rates as per the service provided. It is essential to verify that the information is accurate and corresponds to the patient's specific accommodation type. Regularly updating the charge master to reflect current rates and having a robust verification process in place can help prevent this code from appearing. Additionally, staff training on the importance of entering complete and accurate charge information for each patient stay can reduce the likelihood of receiving an N153 code. Implementing a pre-billing audit process to catch any missing or incorrect data before claims are submitted to the payer can also be an effective strategy.

How to Address Denial Code N153

The steps to address code N153 involve a thorough review of the claim to ensure that the room and board rate information is both present and accurately documented. Begin by cross-referencing the patient's chart and the billing records to confirm the correct room and board charges were captured. If the information is missing or incomplete, obtain the necessary details from the patient's stay records or the facility's standard rate sheet. If the information is invalid, correct the rate to reflect the appropriate charges based on the patient's level of care and the dates of service. Once the correct information is verified, update the claim with the accurate room and board rate and resubmit the claim for processing. It's also advisable to implement a system of checks within your billing software to catch such errors before claims are initially submitted.

CARCs Associated to RARC N153

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