Remark code N653 is an alert that the injury date and reported loss date do not align, requiring verification.
Remark code N653 is an indication that there is a discrepancy between the date of injury as recorded and the date of loss as it has been reported. This discrepancy needs to be addressed for accurate claims processing.
Common causes of code N653 are discrepancies between the date of injury documented in the medical claim and the date of loss reported to the insurance provider, inaccurate or incomplete information provided during the claim submission process, clerical errors in entering the date of injury, or updates to the patient's file that were not communicated to the insurance company.
Ways to mitigate code N653 include implementing a thorough verification process for injury dates during the initial patient intake and documentation phase. Ensure that all staff involved in patient data collection are trained to double-check the accuracy of reported dates against any available documentation, such as accident reports or medical records from previous treatments related to the injury. Utilize electronic health record (EHR) systems with built-in alerts to flag discrepancies between reported injury dates and those documented in the patient's history. Regularly audit patient files for accuracy in reported dates of loss to identify and correct discrepancies before claims submission. Establish a protocol for communication between billing specialists and clinical staff to resolve any inconsistencies in injury dates promptly.
The steps to address code N653 involve a multi-faceted approach to ensure accuracy and compliance in the reporting of injury dates. Initially, it's crucial to review the patient's medical records and any accident reports or documentation that substantiate the date of injury. This may involve consulting with the clinical team or the individual who documented the initial patient intake. If discrepancies are found, correct the date of injury in the billing system and on the claim form to reflect the accurate date.
Next, communicate with the patient to verify the date of injury, as they may provide additional insights or corrections. This step is vital to ensure that all parties have consistent information and to prevent future discrepancies.
If the date of injury has been correctly reported but is still being rejected, gather all supporting documentation that verifies the reported date. This can include medical records, accident reports, or a letter from the treating physician detailing the injury and its date. Submit this documentation to the payer along with a written explanation or appeal, clearly stating why the reported date of injury is accurate and requesting a reevaluation of the claim based on this evidence.
In cases where the payer persists in rejecting the claim due to the reported date of injury, it may be necessary to escalate the issue. This could involve reaching out to a higher authority within the payer organization or seeking assistance from a professional billing advocate or legal advisor who specializes in healthcare claims.
Throughout this process, maintain detailed records of all communications, submissions, and documentation related to addressing code N653. This will be crucial for tracking the progress of your appeal and may be necessary if further escalation is required. Additionally, use this experience as a learning opportunity to review and possibly enhance internal processes for documenting and reporting dates of injury to prevent similar issues in the future.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
