DENIAL CODES

Denial code N214

Remark code N214 indicates a claim denial due to missing or invalid history of initial surgical procedures.

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What is Denial Code N214

Remark code N214 indicates that the claim submitted lacks the necessary information or contains invalid details regarding the history of the related initial surgical procedures. This means that for the claim to be processed, the healthcare provider must provide a complete and accurate surgical history that is relevant to the claim in question.

Common Causes of RARC N214

Common causes of code N214 are:

1. The claim was submitted without the necessary documentation detailing the patient's initial surgical procedure.

2. The information provided about the initial surgery was incomplete, such as missing dates or specific details about the type of surgery performed.

3. The claim form may have contained invalid information, such as incorrect procedure codes or descriptions that do not match the patient's medical records.

4. Electronic Health Records (EHR) or billing systems may have failed to capture and include the history of the initial surgery in the claim submission.

5. There may have been an oversight or error during the coding process, leading to the omission of the surgical history.

6. The payer may require specific documentation or details for the initial surgery that were not provided or were not clear in the submitted claim.

Ways to Mitigate Denial Code N214

Ways to mitigate code N214 include ensuring that all documentation related to the patient's initial surgical procedure is complete, accurate, and properly attached to the claim before submission. This can be achieved by implementing a thorough pre-claim review process that includes a checklist for surgical history details. Additionally, staff training on the importance of capturing all relevant surgical history during patient intake and the use of electronic health records (EHR) with prompts for surgical history can help prevent this code from occurring. Regular audits of claims and supporting documentation can also identify patterns of missing information, allowing for corrective action to be taken.

How to Address Denial Code N214

The steps to address code N214 involve a thorough review of the patient's medical records to ensure that the history of the related initial surgical procedure(s) is accurately documented. Begin by identifying the specific surgical procedure in question and locate the corresponding operative report or clinical notes. If the history is indeed missing or incomplete, reach out to the healthcare provider who performed the initial surgery to obtain the necessary documentation. Once the correct information is acquired, update the patient's records and resubmit the claim with the complete surgical history attached. Ensure that all documentation is clear, legible, and contains the required details such as the date of the initial surgery, the type of procedure performed, and any pertinent outcomes or follow-up care information. Regularly train billing staff on the importance of including comprehensive surgical histories to prevent future occurrences of this code.

CARCs Associated to RARC N214

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