Remark code N525 indicates services aren't covered if performed during another service's global period.
Remark code N525 indicates that the services billed are not eligible for coverage because they were performed during the global period of another service. This means that the payment for these services is included in the reimbursement for the initial service, and separate payment will not be made.
Common causes of code N525 are billing for services that are considered part of the post-operative care during the global period of another, related procedure, attempting to bill separately for services that are included in the global surgical package, or misunderstanding the global period associated with the primary service performed.
Ways to mitigate code N525 include implementing a robust pre-authorization process that checks for any global periods associated with previously performed services. Utilize advanced scheduling systems that flag potential global period conflicts before services are rendered. Educate providers and billing staff on the specifics of global periods, including their duration and the types of services affected. Regularly review and update your coding practices to ensure compliance with the latest guidelines on global periods. Additionally, consider investing in software that automatically detects global period overlaps based on historical patient service data, thereby preventing the submission of claims likely to trigger this code.
The steps to address code N525 involve a multi-faceted approach to ensure accurate billing and reimbursement. Initially, it's crucial to verify the global period associated with the previously performed service to confirm the accuracy of the denial. If the service was indeed performed within the global period of another service, explore if there are exceptions or modifiers that could justify the separate billing of these services. In cases where modifiers are applicable, resubmit the claim with the appropriate modifier attached to the service code. If no modifiers apply, and the denial is accurate, adjust the billing records to reflect the non-covered service and inform the relevant department or provider about the service's non-coverage during the global period to prevent future occurrences. Additionally, consider implementing a system to track global periods for services provided to enhance the accuracy of future billing and minimize denials related to global period overlaps.
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