DENIAL CODES

Denial code N815

Remark code N815 is an alert for a claim issue due to a missing, incomplete, or invalid National Drug Code unit count.

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What is Denial Code N815

Remark code N815 is an indication that the claim has been flagged due to a missing, incomplete, or invalid National Drug Code (NDC) unit count, which is necessary for processing the claim accurately.

Common Causes of RARC N815

Common causes of code N815 (Missing/Incomplete/Invalid NDC National Drug Code Unit Count) are incorrect or missing unit counts on the claim form, entry of the NDC number without the corresponding unit count, use of an incorrect unit of measure that does not match the NDC billed, or submission of a claim with an NDC that requires a specific unit count format not adhered to by the provider. Additionally, this code may be triggered if the documentation provided does not clearly support the unit count billed or if there is a discrepancy between the unit count on the claim and the documentation.

Ways to Mitigate Denial Code N815

Ways to mitigate code N815 include implementing a comprehensive review process for all claims before submission, ensuring that the National Drug Code (NDC) unit count is accurately captured and clearly documented. Training staff on the importance of including complete and precise NDC information can significantly reduce errors. Utilizing specialized billing software that automatically checks for common errors like missing or invalid NDC unit counts can also help. Regularly updating the database with the latest NDC information and establishing a double-check system where a second set of eyes reviews claims, especially those involving medications, can further prevent this issue. Lastly, creating a quick-reference guide for commonly used medications within your practice, including their NDC unit counts, can serve as a valuable resource for billing staff.

How to Address Denial Code N815

The steps to address code N815 involve a meticulous review and correction process for the National Drug Code (NDC) unit count information on the claim. Initially, verify the accuracy of the NDC itself to ensure it matches the medication provided. Following this, confirm the unit count is accurately documented, reflecting the precise amount of medication administered or prescribed. If discrepancies are found, correct the unit count to match the medication's actual administered or prescribed quantity. It's crucial to cross-reference this information with the patient's medical records and the pharmacy or medication administration documentation to ensure accuracy. Once corrections are made, resubmit the claim with the updated and accurate NDC unit count information. Additionally, implementing a double-check system for future claims can prevent similar issues, ensuring NDC unit counts are accurately recorded before initial claim submission.

CARCs Associated to RARC N815

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