DENIAL CODES

Denial code N670

Remark code N670 indicates the service code is the primary procedure for Medicare's Multiple Procedure Payment Reduction rule.

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What is Denial Code N670

Remark code N670 indicates that the service code billed has been identified as the primary procedure code subject to the Medicare Multiple Procedure Payment Reduction (MPPR) rule.

Common Causes of RARC N670

Common causes of code N670 are incorrect primary procedure code selection when billing for multiple procedures, failure to apply the Medicare Multiple Procedure Payment Reduction (MPPR) rule correctly, or misunderstanding of which services are subject to the MPPR rule. Additionally, this code may appear if there is an error in the sequencing of procedure codes, indicating that the primary procedure was not identified accurately according to Medicare guidelines.

Ways to Mitigate Denial Code N670

Ways to mitigate code N670 include implementing a comprehensive review process within your billing system to identify and adjust claims subject to the Medicare Multiple Procedure Payment Reduction (MPPR) rule before submission. Training your coding team on the specifics of MPPR and how it affects billing for primary and subsequent procedures can help ensure that claims are coded correctly from the outset. Utilizing advanced coding software that automatically flags services impacted by MPPR can also aid in preventing this code from appearing on your claims. Additionally, conducting regular audits of your billing processes to identify patterns that may lead to the application of code N670 and adjusting your practices accordingly can be beneficial. Engaging in continuous education about changes in Medicare policies, including MPPR, will keep your team informed and proactive in avoiding this and similar codes.

How to Address Denial Code N670

The steps to address code N670 involve a multi-faceted approach to ensure accurate reimbursement despite the Medicare Multiple Procedure Payment Reduction (MPPR) rule. First, verify the accuracy of the coding for all procedures performed during the same session to ensure that the primary procedure is correctly identified and that all secondary procedures are eligible for the MPPR. Next, re-evaluate the billing order of procedures to confirm that the procedure with the highest reimbursement rate is listed as the primary procedure, as this can impact the overall reduction applied under MPPR.

Additionally, it's crucial to review the practice's current billing software or system to ensure it's updated to automatically apply MPPR rules correctly, preventing manual errors. Engage with your billing team or outsourced RCM provider to conduct regular audits on claims affected by MPPR to identify patterns or recurring issues that could be rectified through staff training or process adjustments.

For claims already submitted and impacted by code N670, consider the feasibility of appealing the payment decision if there was an error in how the reduction was applied or if there is a legitimate rationale for an exception based on the specific circumstances of the case. This might involve gathering detailed documentation and a clear explanation to support the appeal.

Lastly, keep abreast of any changes to the MPPR rules by Medicare, as updates could affect how reductions are calculated or applied, necessitating adjustments in billing practices to optimize reimbursement. Engaging in continuous education and training for coding and billing staff on the nuances of MPPR and other similar rules can also help minimize future occurrences of code N670 negatively impacting reimbursement.

CARCs Associated to RARC N670

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