DENIAL CODES

Denial code N752

Remark code N752 is an alert for missing or invalid HIPPS Treatment Authorization Code, indicating a need for correct submission.

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What is Denial Code N752

Remark code N752 is an indication that there is an issue with the HIPPS (Health Insurance Prospective Payment System) Treatment Authorization Code (TAC). Specifically, it means that the TAC is either missing, incomplete, or invalid in the submitted claim. This code alerts healthcare providers that they need to review and correct the TAC information to ensure proper processing and reimbursement of the claim.

Common Causes of RARC N752

Common causes of code N752 (Missing/incomplete/invalid HIPPS Treatment Authorization Code (TAC)) are:

1. The HIPPS (Health Insurance Prospective Payment System) code was not included on the claim submission, which is required for processing.
2. The submitted HIPPS code does not match the treatment or services provided, indicating a potential error in code selection.
3. The HIPPS code provided is outdated or has been revised, and the updated code was not used in the claim.
4. The claim form was filled out incorrectly or incompletely, leading to the omission of the HIPPS code.
5. There was a data entry error when inputting the HIPPS code, resulting in an invalid code being submitted.
6. The authorization for the treatment was not properly documented or linked with the HIPPS code, leading to a discrepancy in the claim.

Ways to Mitigate Denial Code N752

Ways to mitigate code N752 include ensuring that the Health Insurance Prospective Payment System (HIPPS) Treatment Authorization Code (TAC) is accurately captured and entered into the billing system. This can be achieved by implementing a thorough review process for all claims before submission, focusing on the completeness and validity of the HIPPS TAC. Training billing staff on the specific requirements and common errors related to HIPPS TAC can also significantly reduce the occurrence of this issue. Additionally, utilizing automated software that checks for missing or invalid data can help catch and correct errors before claims are submitted. Establishing a routine audit of claims, specifically looking for HIPPS TAC-related errors, will further ensure that such issues are identified and addressed promptly, minimizing the risk of receiving code N752.

How to Address Denial Code N752

The steps to address code N752 involve a multi-faceted approach to ensure the completeness and accuracy of the Health Insurance Prospective Payment System (HIPPS) Treatment Authorization Code (TAC). First, conduct a thorough review of the patient's medical records and treatment plan to verify the correct HIPPS code that reflects the patient's clinical complexity and resource needs. Next, cross-reference this information with the coding guidelines to ensure the selected HIPPS code is valid and accurately represents the authorized services.

If the HIPPS TAC is found to be missing or incomplete, promptly obtain the necessary authorization from the appropriate party, which may involve contacting the patient's insurance provider or the referring physician to gather additional information or clarification. Ensure that all communication and authorization are documented thoroughly in the patient's record.

In cases where the HIPPS TAC is invalid, identify the discrepancy by comparing the code used with the official coding resources or software. Update the patient's billing record with the correct HIPPS TAC, ensuring that any changes are made in accordance with the latest coding standards and guidelines.

After rectifying the issue, resubmit the claim with the correct or complete HIPPS TAC. It's crucial to monitor the claim's status after resubmission to ensure it is processed successfully and to address any further issues promptly. Additionally, consider implementing a quality control process to review HIPPS codes before initial claim submission to minimize the occurrence of code N752 and enhance the overall efficiency of your billing process.

CARCs Associated to RARC N752

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