DENIAL CODES

Denial code N262

Remark code N262 indicates an issue with the operating provider's primary identifier, such as it being missing or incorrect.

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What is Denial Code N262

Remark code N262 indicates that the claim submitted lacks a complete or valid primary identifier for the operating provider involved in the service. This means that the information necessary to uniquely identify the provider who performed the surgery or procedure is either not present, incomplete, or incorrect on the claim form. To resolve this issue, the healthcare provider must provide the correct and complete identifier before the claim can be processed and considered for payment.

Common Causes of RARC N262

Common causes of code N262 are:

1. The operating provider's National Provider Identifier (NPI) is not included on the claim.

2. The NPI provided on the claim is incorrect or does not match the records with the payer.

3. The claim form is missing the required qualifier to indicate the type of provider identifier being used.

4. The claim was submitted without the necessary information to distinguish between multiple providers who participated in the service.

5. The operating provider's information was entered in the incorrect field or location on the claim form.

6. The claim was submitted with outdated or deactivated provider information due to changes in the provider's status or practice.

7. The provider's taxonomy code, which further specifies the type of practice or specialty, is missing or incorrect alongside the NPI.

8. The claim lacks the necessary credentials or documentation to support the operating provider's role in the procedure or service rendered.

Ways to Mitigate Denial Code N262

Ways to mitigate code N262 include implementing a robust verification process to ensure that all claims include the correct and complete primary identifier for the operating provider before submission. This can be achieved by:

1. Training staff on the importance of capturing accurate provider information and the specific requirements for the operating provider's primary identifier.
2. Utilizing electronic health record (EHR) systems that prompt for the necessary provider identifier details during the documentation process.
3. Establishing a pre-claim submission review protocol where claims are audited for completeness and accuracy of provider identifiers.
4. Integrating automated checks within the billing software that flag claims with missing or incomplete provider identifiers.
5. Keeping an updated database of all operating providers' National Provider Identifiers (NPIs) and other required identification numbers to facilitate easy retrieval and verification.
6. Regularly communicating with operating providers to ensure that any changes in their identifier information are promptly updated in the system.
7. Setting up alerts or reminders for credentialing staff to verify and update provider identifiers at regular intervals or when notified of changes.

By focusing on these strategies, healthcare providers can reduce the occurrence of code N262 and improve the efficiency of their revenue cycle management.

How to Address Denial Code N262

The steps to address code N262 involve a thorough review of the claim to identify the missing or incorrect information regarding the operating provider's primary identifier. Begin by verifying the accuracy of the provider's National Provider Identifier (NPI) on the claim. If the NPI is missing, obtain the correct NPI from the provider's records or the National Plan & Provider Enumeration System (NPPES) and update the claim accordingly. If the NPI is present but incorrect, correct the NPI number and ensure that it matches the provider's information on file with the payer. Additionally, check for any other required identifiers or credentials that may be necessary for the operating provider based on the payer's requirements. Once all the necessary corrections are made, resubmit the claim to the payer for processing. It's also advisable to review your claim submission process to prevent similar issues in future claims.

CARCs Associated to RARC N262

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