Denial code N846

Remark code N846 indicates the National Drug Code (NDC) provided does not match the HCPCS/CPT code billed.

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What is Denial Code N846

Remark code N846 is an indication that the National Drug Code (NDC) provided does not match the Healthcare Common Procedure Coding System (HCPCS) or Current Procedural Terminology (CPT) code that was billed.

Common Causes of RARC N846

Common causes of code N846 are incorrect entry of the National Drug Code (NDC) number, mismatches between the NDC and the Healthcare Common Procedure Coding System (HCPCS) or Current Procedural Terminology (CPT) codes due to outdated billing databases, clerical errors during the billing process, and discrepancies arising from recent changes in drug formulations or packaging that have not been updated in the payer's system.

Ways to Mitigate Denial Code N846

Ways to mitigate code N846 include ensuring that the billing team is thoroughly trained in the accurate association of National Drug Codes (NDC) with the corresponding Healthcare Common Procedure Coding System (HCPCS) or Current Procedural Terminology (CPT) codes. Implementing a robust verification process before claims submission, which includes cross-referencing NDCs with the billed HCPCS/CPT codes using updated drug compendia and payer formularies, can significantly reduce the occurrence of this issue. Utilizing advanced billing software that automatically flags discrepancies between NDCs and HCPCS/CPT codes for review can also help prevent this error. Regularly updating the drug code database in your billing system to reflect changes in drug formulations, strengths, or packaging sizes ensures that the NDCs remain current and accurate. Additionally, fostering open communication channels with pharmacists and providers to confirm drug information and its corresponding billing codes can further mitigate the risk of receiving code N846.

How to Address Denial Code N846

The steps to address code N846 involve a multi-faceted approach to ensure accurate billing and compliance with coding standards. Initially, conduct a thorough review of the claim in question to verify the National Drug Code (NDC) and the Healthcare Common Procedure Coding System (HCPCS) or Current Procedural Terminology (CPT) codes used. This involves comparing the NDC provided on the claim with the drug's actual NDC as per the manufacturer's labeling or packaging. If a discrepancy is found, correct the NDC on the claim to match the appropriate drug code.

Next, re-evaluate the HCPCS or CPT code billed to ensure it accurately reflects the service provided, including the specific drug administered. It's crucial to cross-reference the corrected NDC with the appropriate HCPCS or CPT code to ensure alignment. This may involve consulting updated drug coding resources or databases to verify the correct pairing of NDC and procedure codes.

If the initial claim was denied due to this discrepancy, prepare and submit a corrected claim with the accurate NDC and corresponding HCPCS or CPT code. Include any supporting documentation that may assist in validating the correction, such as manufacturer's drug information or a detailed explanation of the service provided.

To prevent future occurrences of code N846, implement a quality assurance process for reviewing and verifying NDC and HCPCS/CPT code pairings before claim submission. This could involve training staff on the importance of accurate drug coding and establishing a routine check of coding updates or changes that could affect drug-procedure code pairings.

Lastly, consider utilizing electronic health record (EHR) systems or billing software that automatically checks for discrepancies between NDCs and HCPCS/CPT codes as an additional safeguard. This technology can provide real-time alerts when mismatches occur, allowing for immediate correction before claims submission.

CARCs Associated to RARC N846

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