Remark code N222 indicates that the Admitting History and Physical report submitted with the claim is incomplete or invalid. This means that the documentation provided does not meet the necessary criteria or is missing required information, and as a result, the claim may be delayed or denied until a complete and valid report is received.
Common causes of code N222 are missing documentation for the patient's admitting history and physical examination report, improperly formatted or incomplete reports, and failure to include required information such as the date of the examination, the physician's signature, or relevant clinical findings. Additionally, this code may be triggered if the report does not meet the payer's specific criteria or if it was not submitted within the required timeframe.
Ways to mitigate code N222 include implementing a thorough review process for all Admitting History and Physical reports before submission. Ensure that the documentation is complete and includes all required elements such as patient history, physical examination findings, and physician's clinical impressions. Utilize electronic health record (EHR) systems with built-in prompts and alerts to flag incomplete sections. Provide regular training for staff on the importance of comprehensive documentation and the specific details that must be included in these reports. Establish a quality assurance team to conduct periodic audits of Admitting History and Physical reports to identify and correct any patterns of incomplete or invalid information.
The steps to address code N222 involve a thorough review of the patient's medical records to ensure that the Admitting History and Physical (H&P) report is complete and accurately documented. Begin by identifying any missing components or information that may have led to the code being assigned. Collaborate with the clinical staff to obtain the necessary details or clarification required to rectify the documentation. Once the H&P report is updated and validated for completeness and accuracy, resubmit the claim with the revised documentation attached. It's also advisable to implement a process for a pre-submission review of H&P reports to prevent future occurrences of this issue.