Remark code N75 indicates that the claim has been flagged due to missing, incomplete, or invalid information regarding the surface of the tooth that was treated or examined. This code is used to communicate that the dental claim cannot be processed without the correct and complete data about the specific tooth surfaces involved in the procedure.
Common causes of code N75 are:
1. The dental claim form was submitted without indicating the specific tooth surfaces that were treated, such as the mesial, distal, buccal, lingual, or occlusal surfaces.
2. The tooth surface information provided on the claim is illegible or not in a recognizable format, leading to confusion or misinterpretation.
3. The procedure code reported may require specific tooth surface information, but it was omitted or not specified in the claim documentation.
4. Incorrect or incomplete electronic data interchange (EDI) mapping may have resulted in the tooth surface information not being transmitted correctly to the payer.
5. The dental provider may have used outdated or incorrect coding that does not align with current dental coding standards, which require detailed tooth surface information for certain procedures.
6. There may have been an administrative oversight where the tooth surface information was known but accidentally not included on the claim form before submission.
Ways to mitigate code N75 include ensuring that all dental claim forms are thoroughly reviewed for completeness before submission. Implement a checklist that includes tooth surface information as a required field for relevant procedures. Train staff on the importance of providing detailed and accurate dental descriptions, including the use of correct dental codes that require tooth surface data. Utilize electronic health record (EHR) systems with built-in alerts to flag claims that lack necessary tooth surface information. Regularly audit dental claims to identify and address any recurring issues with missing or incomplete data. Establish a protocol for timely follow-up on denied claims to correct and resubmit them with the required tooth surface information.
The steps to address code N75 involve reviewing the dental claim form to ensure that all required fields related to tooth surface information are accurately completed. If the information is missing or incomplete, obtain the correct details from the dental provider's records or by consulting with the dental provider directly. Update the claim with the valid tooth surface information, ensuring that it aligns with the procedure codes billed. Once the claim has been corrected, resubmit it to the payer for processing. It's also advisable to audit your claim submission process to identify why the tooth surface information was initially omitted or incorrect, and implement measures to prevent similar issues in future claims.