Denial code N231

Remark code N231 indicates an invalid or incomplete invoice/statement for the cost of a lens or the type of intraocular lens used.

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What is Denial Code N231

Remark code N231 indicates that the claim submitted has been flagged due to an incomplete or invalid invoice or statement. This means that the documentation provided did not sufficiently certify the actual cost of the intraocular lens, taking into account any discounts, or it failed to specify the type of intraocular lens used. To resolve this issue, the healthcare provider must review the claim, ensure that all necessary information is accurate and complete, and resubmit the claim with the correct documentation.

Common Causes of RARC N231

Common causes of code N231 are:

1. Submission of an invoice or statement that lacks the necessary details regarding the actual cost of the intraocular lens.

2. Failure to include any applicable discounts on the invoice or statement that would affect the actual cost of the lens.

3. Omission of the specific type or model of the intraocular lens used in the procedure on the accompanying documentation.

4. Providing an invoice or statement that does not meet the payer's specific requirements for certification of costs and lens type.

5. Errors in the documentation process where the invoice or statement was not properly reviewed or verified before submission.

Ways to Mitigate Denial Code N231

Ways to mitigate code N231 include ensuring that the invoice or statement provided is fully completed with accurate details. This should include a clear certification of the actual cost of the lens, accounting for any discounts applied. Additionally, the specific type of intraocular lens used must be documented. It's important to double-check that all required fields are filled out before submission and to maintain thorough records that can be easily referenced or resubmitted if necessary. Regular training for billing staff on the proper documentation and certification processes can also help prevent this code from occurring.

How to Address Denial Code N231

The steps to address code N231 involve several key actions to ensure proper documentation and verification. First, review the invoice or statement in question to identify any missing or incorrect information regarding the actual cost of the lens, including any applicable discounts. Next, ensure that the type of intraocular lens used is clearly specified and documented. If necessary, obtain a corrected invoice or statement from the supplier that includes all required details. Once you have the complete and accurate documentation, resubmit the claim with the attached invoice or statement to the payer. Additionally, consider implementing a checklist for future intraocular lens claims to prevent this issue from recurring.

CARCs Associated to RARC N231

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