Remark code N184 indicates that the technical and professional components of the billed service should be itemized and submitted as separate claims for reimbursement. This separation allows for distinct processing and payment of the facility or equipment usage (technical component) and the professional service provided by the healthcare practitioner (professional component).
Common causes of code N184 are:
1. The claim was submitted with both technical and professional components billed together under a single charge, when they should have been billed separately.
2. Incorrect use of modifier -TC (Technical Component) or -26 (Professional Component) on the claim, leading to confusion about the services provided.
3. The billing system automatically combined charges for technical and professional services, which are required to be itemized individually for certain procedures or payers.
4. Lack of understanding or oversight regarding payer-specific billing requirements for certain services that necessitate separate billing of technical and professional components.
5. The claim form may have been filled out incorrectly, with an error in the service lines that combine technical and professional fees.
6. The provider may have rendered both components of a service but failed to follow the correct protocol for splitting the services into two distinct claims as required by the payer's guidelines.
Ways to mitigate code N184 include implementing a thorough review process to ensure that claims for services with both technical and professional components are split correctly before submission. Staff should be trained to recognize procedures that require separate billing for each component and use appropriate modifiers. Additionally, investing in billing software that automatically flags these services can help prevent the bundling of charges that should be itemized. Regular audits of billing practices can also identify patterns that lead to this remark code, allowing for corrective action to be taken proactively.
The steps to address code N184 involve reviewing the claim to identify the services that were billed together but should have been itemized as technical and professional components. Begin by separating the charges into two distinct claims: one for the technical component, which covers facility resources used during the service, and another for the professional component, which accounts for the healthcare provider's expertise and time. Ensure that each claim uses the appropriate modifiers to indicate the split billing. After the claims have been correctly separated, resubmit them to the payer for processing. It's also advisable to audit your coding practices to prevent similar issues in future billing cycles.