Remark Code N857 means that a claim has been adjusted or reversed, and any collected copayment should be refunded to the member. This code is used to indicate the reason for the adjustment or reversal of a claim and serves as a notification to healthcare providers and insurance companies. 1. Description Remark Code N857 indicates…

Remark Code N858 means that state regulations relating to an Out of Network Medical Emergency Care Act were applied to the processing of a claim. This code is used to alert healthcare providers and insurance companies that payment amounts are eligible for dispute following the state’s documented appeal/grievance/arbitration process. 1. Description Remark Code N858 indicates…

Remark Code N859 means that the Federal No Surprise Billing Act was applied to the processing of the claim. This code indicates that the payment amounts are eligible for dispute pursuant to any Federal documented appeal/grievance/dispute resolution process(es). It is important to understand the implications of this code and take appropriate steps to address any…

Remark Code N860 means that the Federal No Surprise Billing Act Qualified Payment Amount (QPA) was used to calculate the member cost share(s). This code serves as an alert to healthcare providers and insurance companies regarding the calculation of member cost shares in accordance with the Federal No Surprise Billing Act. 1. Description Remark Code…

Remark Code N861 means that there is a mismatch between the submitted Patient Liability/Share of Cost and the amount on record for this recipient. This code serves as an alert to healthcare providers and insurance companies that there is an inconsistency in the financial responsibility of the patient. 1. Description Remark Code N861 indicates that…

Remark Code N846 means that the National Drug Code (NDC) supplied does not correspond to the HCPCs/CPT billed. This code is often used by medical coders and insurance companies to indicate that there is a discrepancy between the drug code provided and the code billed for a particular service or procedure. 1. Description Remark Code…

Remark Code N862 means that the member’s cost share is in compliance with the No Surprises Act and is calculated using the lesser of the Qualified Payment Amount (QPA) or the billed charge. This code is used to alert healthcare providers and insurance companies about the calculation of the member’s cost share, ensuring compliance with…

Remark Code N847 means that the National Drug Code (NDC) billed is obsolete. This code is used to indicate that the NDC associated with a particular drug or medication is no longer valid or in use. Healthcare providers and insurance companies utilize this code to explain the reason for denial or adjustment of a claim…

Remark Code N863 means that the claim is subject to the No Surprises Act (NSA) and the amount paid is the final out-of-network rate. This code is used to alert healthcare providers and insurance companies that the payment was calculated based on an All Payer Model Agreement, in accordance with the NSA. 1. Description Remark…

Remark Code N848 means that the National Drug Code (NDC) billed cannot be associated with a product. This code is often used by healthcare providers and insurance companies to indicate the reason for denial or adjustment of a claim related to drug products. 1. Description Remark Code N848 indicates that the National Drug Code (NDC)…