Remark code N221 indicates that the claim has been flagged because it lacks the necessary Admitting History and Physical report. This documentation is required to process the claim, and its absence may result in a delay or denial of payment. Healthcare providers should ensure that this report is included with the claim submission to avoid issues with reimbursement.
Common causes of code N221 are incomplete patient documentation at the time of admission, failure to upload or attach the Admitting History and Physical report to the patient's electronic health record, clerical errors during the data entry process, or the report being misplaced or lost prior to billing. Additionally, this code may be triggered if there is a discrepancy between the dates of service and the dates the Admitting History and Physical report was completed, suggesting that the report does not correspond to the admission in question.
Ways to mitigate code N221 include implementing a thorough pre-billing checklist that ensures all necessary documentation, such as the Admitting History and Physical report, is present before claims submission. Training staff to recognize and collect required reports at the time of patient admission can also help prevent this issue. Additionally, utilizing an electronic health record (EHR) system with prompts or alerts for missing documentation can aid in ensuring that all relevant information is included with the claim. Regular audits of claim denials should be conducted to identify patterns that can be addressed through staff education or process improvement.
The steps to address code N221 involve several key actions to resolve the issue and prevent future occurrences. First, review the patient's records to confirm if the Admitting History and Physical report was indeed performed but not included in the claim submission. If the report is missing, coordinate with the relevant clinical department to obtain the necessary documentation. Once the report is secured, resubmit the claim with the Admitting History and Physical report attached. To prevent this error in the future, implement a checklist for claim submissions to ensure all required documentation, including the Admitting History and Physical report, is included before the claim is sent to the payer. Additionally, consider training staff on the importance of thorough documentation and the impact it has on the revenue cycle. Regular audits of claim submissions can also help identify patterns of missing documentation and areas for process improvement.