DENIAL CODES

Denial code N816

Remark code N816 is an alert for missing or invalid National Drug Code (NDC) unit of measure in billing documents.

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What is Denial Code N816

Remark code N816 is an indication that there is an issue with the National Drug Code (NDC) unit of measure provided in the claim. This means that the NDC unit of measure is either missing, incomplete, or invalid, and needs to be corrected for the claim to be processed.

Common Causes of RARC N816

Common causes of code N816 (Missing/Incomplete/Invalid NDC National Drug Code Unit of Measure) are incorrect or missing entries for the unit of measure associated with a specific NDC on a claim, use of outdated or incorrect NDC numbers that do not match the unit of measure in the payer's database, or submission of claims with NDCs without specifying the required unit of measure (e.g., ML for milliliters, GR for grams, UN for units). Additionally, this code can be triggered by discrepancies between the billed NDC unit of measure and the actual dispensed medication's unit of measure, or by data entry errors when inputting the NDC unit of measure into the billing system.

Ways to Mitigate Denial Code N816

Ways to mitigate code N816 include implementing a comprehensive review system for all claims before submission, ensuring that the National Drug Code (NDC) unit of measure is accurately captured and recorded. Training staff on the importance of detailed and precise documentation can also significantly reduce the occurrence of this issue. Utilizing software that automatically checks for common errors, such as missing or invalid NDC units of measure, can further streamline the process and prevent this code from arising. Regular audits of claims can help identify patterns or recurring mistakes in documentation, allowing for targeted training or process adjustments. Establishing a clear communication channel with pharmacy staff to verify the NDC unit of measure at the point of prescribing or dispensing can also be beneficial.

How to Address Denial Code N816

The steps to address code N816 involve a detailed review and correction process to ensure the National Drug Code (NDC) unit of measure is accurately reported. Begin by cross-referencing the billed item with the pharmacy or medication administration records to verify the correct NDC number and its associated unit of measure. If discrepancies are found, correct the claim by inputting the accurate NDC unit of measure, such as ML (milliliter), GR (gram), or UN (unit), depending on the medication administered. It's crucial to consult the drug manufacturer's documentation or the FDA's NDC directory for the correct unit of measure if there's any uncertainty. After making the necessary corrections, resubmit the claim with the updated information. To prevent future occurrences of this code, consider implementing a verification step in your billing process that checks for the completeness and validity of the NDC unit of measure before initial claim submission.

CARCs Associated to RARC N816

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