DENIAL CODES

Denial code N812

Remark code N812 indicates that service dates must not exceed an 18-month span between start and end dates.

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What is Denial Code N812

Remark code N812 is an indication that the claim submitted spans a service period exceeding 18 months from the start date to the end date, which is not permissible.

Common Causes of RARC N812

Common causes of code N812 are:

1. Incorrect entry of service dates by the billing staff, leading to an accidental span of more than 18 months between the start and end service dates.

2. Misinterpretation of the service period by the coder or biller, especially in cases of ongoing treatments or services that are billed periodically.

3. System errors or glitches in the electronic health record (EHR) or practice management software that automatically populate service dates incorrectly.

4. Delays in billing for services rendered, causing the submission of claims for services that, when combined with more recent services, exceed the 18-month span.

5. Miscommunication between healthcare providers and billing departments regarding the actual dates of service, leading to erroneous billing information being submitted.

6. Failure to update or correct service dates after a claim denial, resulting in repeated submission of claims with the same error.

7. Lack of awareness or misunderstanding of payer-specific guidelines regarding the acceptable span of service dates for billing purposes.

Ways to Mitigate Denial Code N812

Ways to mitigate code N812 include implementing rigorous checks within your billing software to automatically flag and prevent the submission of claims where the service period exceeds 18 months. Additionally, training billing staff to carefully review service dates before claim submission and establishing a pre-claim submission review process can help catch and correct date errors. Regularly auditing service date entries for accuracy and consistency can also reduce the occurrence of this issue.

How to Address Denial Code N812

The steps to address code N812 involve a thorough review and potential correction of the service dates on the claim. Initially, verify the accuracy of both the start and end service dates entered. If an error is found in the dates, correct them to ensure they reflect the actual service period and resubmit the claim. If the dates are accurate but span more than 18 months due to the nature of the services provided, consider splitting the claim into two or more claims so that each claim period does not exceed the 18-month span. Ensure that each claim accurately reflects the services provided within its specific time frame. Additionally, review any accompanying documentation to ensure it supports the services billed within each claim period. After making the necessary adjustments, resubmit the claims for processing.

CARCs Associated to RARC N812

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