How To Fix Remark Code M301 (RARC) | Common Reasons, Next Steps & How To Avoid It

Remark Code N81 means that the procedure billed is not compatible with the tooth surface code. This code is used to indicate that there is an issue with the compatibility of the procedure and the specific tooth surface being treated. It is important for medical coders to understand this code in order to accurately process claims and ensure proper reimbursement.

1. Description

Remark Code N81 indicates that the procedure billed is not compatible with the tooth surface code. The official description states: ‘Procedure billed is not compatible with tooth surface code.’ This means that there is a discrepancy between the procedure performed and the specific tooth surface that was treated. It is crucial to accurately code the tooth surface in order to ensure proper billing and reimbursement.

2. Common Reasons

1. Incorrect tooth surface coding: One of the most common reasons for Remark Code N81 is when the tooth surface code is incorrectly assigned. This can happen due to human error or lack of understanding of the coding guidelines.
2. Incompatible procedure performed: Another reason for this remark code is when the procedure performed is not compatible with the specific tooth surface being treated. This could be due to a misunderstanding of the treatment plan or a mistake made during the procedure.
3. Lack of documentation: Insufficient documentation can also lead to Remark Code N81. If the dental records do not clearly indicate the tooth surface that was treated, it becomes difficult to accurately assign the correct code.

3. Next Steps

1. Review the dental records: The first step in addressing Remark Code N81 is to thoroughly review the dental records. Ensure that the documentation clearly indicates the tooth surface that was treated and cross-reference it with the procedure performed.
2. Consult with the dental provider: If there is any confusion or discrepancy regarding the tooth surface coding, it is important to consult with the dental provider. They can provide clarification and additional information to help resolve the issue.
3. Correct the coding: If it is determined that the tooth surface coding was incorrect, it is necessary to correct it in the claim. This may involve submitting an appeal or resubmitting the claim with the accurate coding.

4. How To Avoid It

1. Ensure accurate tooth surface coding: To avoid Remark Code N81, it is crucial to assign the correct tooth surface code based on the treatment provided. This requires a thorough understanding of dental coding guidelines and careful attention to detail.
2. Provide clear documentation: Clear and detailed documentation is essential to support the assigned tooth surface code. Dental providers should ensure that the dental records clearly indicate the tooth surface that was treated.
3. Regularly update coding knowledge: Dental coders should stay updated with the latest coding guidelines and attend relevant training sessions to enhance their coding skills and minimize errors.

5. Example Cases

1. Case 1: A claim is denied due to Remark Code N81 because the procedure billed is not compatible with the tooth surface code. Upon review, it is discovered that the tooth surface coding was incorrectly assigned, leading to the denial. The coding is corrected, and the claim is resubmitted for reimbursement.
2. Case 2: A claim adjustment occurs because the dental records do not clearly indicate the tooth surface that was treated. The lack of documentation makes it impossible to accurately assign the tooth surface code. The dental provider is contacted to provide additional information, and the claim is adjusted accordingly.

Source: Remittance Advice Remark Codes