How To Fix Remark Code M298 (RARC) | Common Reasons, Next Steps & How To Avoid It

Remark Code N78 means that the necessary components of the child and teen checkup (EPSDT) were not completed. This code is used to indicate that certain requirements for the checkup were not fulfilled, leading to denial or adjustment of a claim. Understanding the reasons behind this code and taking appropriate steps can help ensure that the necessary components are completed in future checkups.

1. Description

Remark Code N78 indicates that the necessary components of the child and teen checkup (EPSDT) were not completed. The official description states: ‘The necessary components of the child and teen checkup (EPSDT) were not completed.’ This code serves as a reminder to healthcare providers and insurance companies that specific requirements for the checkup were not met.

2. Common Reasons

1. Missing immunizations: One of the common reasons for Remark Code N78 is the absence of required immunizations during the child and teen checkup. Immunizations play a crucial role in preventing diseases and promoting overall health.
2. Incomplete physical examination: Another reason for this code is an incomplete physical examination. The child and teen checkup typically includes a comprehensive physical examination to assess the child’s growth, development, and overall well-being.
3. Lack of developmental screenings: Developmental screenings are an essential part of the child and teen checkup. These screenings help identify any developmental delays or concerns early on, allowing for timely interventions and support.
4. Failure to provide required preventive services: The child and teen checkup often includes various preventive services, such as vision and hearing screenings, dental assessments, and behavioral health screenings. Remark Code N78 may be triggered if these services are not provided.

3. Next Steps

1. Review the checklist for child and teen checkup: Healthcare providers should ensure they have a comprehensive checklist that outlines all the necessary components of the child and teen checkup. This checklist can serve as a guide to ensure that no essential elements are missed.
2. Educate healthcare staff: It is crucial to educate healthcare staff about the specific requirements of the child and teen checkup. Regular training sessions and updates can help ensure that all staff members are aware of the necessary components and their importance.
3. Implement reminder systems: Utilizing reminder systems, such as electronic health record alerts or appointment scheduling software, can help healthcare providers stay on top of the necessary components of the child and teen checkup. These systems can send reminders to both healthcare providers and patients, ensuring that all requirements are met.

4. How To Avoid It

1. Develop a standardized process: Establishing a standardized process for the child and teen checkup can help ensure that all necessary components are consistently completed. This process should include clear guidelines and protocols for immunizations, physical examinations, developmental screenings, and preventive services.
2. Regularly update checkup guidelines: Stay updated with the latest guidelines and recommendations for the child and teen checkup. As new evidence emerges, guidelines may change, and it is essential to incorporate these updates into the checkup process.
3. Enhance communication with patients: Effective communication with patients and their families is crucial for the successful completion of the child and teen checkup. Clearly explain the importance of each component and address any concerns or questions they may have.

5. Example Cases

1. Case 1: A claim for a child and teen checkup is denied because the required immunizations were not administered. This case highlights the significance of ensuring all immunizations are up to date during the checkup.
2. Case 2: A claim adjustment occurs because the developmental screenings were not conducted during the child and teen checkup. This case emphasizes the importance of comprehensive developmental assessments to identify any potential delays or concerns.

Source: Remittance Advice Remark Codes