DENIAL CODES

Denial code N759

Remark code N759 is an adjustment to payment based on compliance with NEMA Standard XR-29-2013 for imaging efficiency.

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What is Denial Code N759

Remark code N759 is an indication that the payment has been adjusted in accordance with the National Electrical Manufacturers Association (NEMA) Standard XR-29-2013. This standard pertains to the compliance requirements for computed tomography (CT) equipment, focusing on dose optimization and patient safety enhancements.

Common Causes of RARC N759

Common causes of code N759 are the use of non-compliant CT equipment that does not meet the National Electrical Manufacturers Association (NEMA) Standard XR-29-2013 specifications, failure to update CT equipment to adhere to current standards, or incorrect documentation or coding indicating non-compliance with the NEMA Standard XR-29-2013.

Ways to Mitigate Denial Code N759

Ways to mitigate code N759 include implementing a comprehensive review and update of all imaging equipment to ensure compliance with the National Electrical Manufacturers Association (NEMA) Standard XR-29-2013. This involves conducting regular audits of your imaging equipment inventory to identify any machines that do not meet the standard. Once identified, plan for upgrades or replacements of non-compliant equipment. Additionally, staff training on the importance of using compliant equipment and the potential financial impacts of non-compliance is crucial. Establishing a routine maintenance and inspection schedule for imaging equipment can also help in identifying compliance issues before they result in adjustments to payments. Lastly, maintaining clear and accessible records of equipment compliance can expedite the review process and support appeals if necessary.

How to Address Denial Code N759

The steps to address code N759 involve a multi-faceted approach focusing on compliance with the National Electrical Manufacturers Association (NEMA) Standard XR-29-2013. First, conduct a thorough review of your current imaging equipment inventory to identify machines that do not meet the NEMA XR-29-2013 standards. This includes assessing the capabilities related to dose optimization and ensuring that the equipment can provide necessary reporting for dose exposure.

Next, develop a plan to upgrade non-compliant equipment. This may involve scheduling upgrades with the manufacturer, exploring options for purchasing new compliant machines, or investigating retrofitting existing equipment with compliant features. It's crucial to prioritize upgrades based on the equipment's usage rate and the potential impact on patient safety and billing processes.

Simultaneously, update your billing and coding practices to reflect the compliance status of your equipment. This includes training your coding team on how to accurately document the use of compliant versus non-compliant equipment and adjusting your billing processes to prevent future occurrences of code N759.

Additionally, implement a monitoring system to ensure ongoing compliance. This could involve regular audits of equipment and billing practices, as well as staying informed about any updates to the NEMA standards or related billing requirements.

Lastly, if you've received code N759 for services already rendered with non-compliant equipment, prepare and submit a detailed appeal if applicable. This appeal should include documentation of your compliance efforts, any extenuating circumstances, and a clear plan for preventing future occurrences. Engaging with a healthcare attorney or a consultant specialized in healthcare compliance may be beneficial to strengthen your appeal process.

CARCs Associated to RARC N759

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