How To Fix Remark Code M393 (RARC) | Common Reasons, Next Steps & How To Avoid It

Remark Code N182 means that this claim/service must be billed according to the schedule for this plan. This code is used to indicate that the billing for a particular claim or service needs to adhere to the specific schedule outlined by the insurance plan. Understanding and following the billing guidelines is crucial to ensure accurate reimbursement and avoid claim denials or adjustments.

1. Description

Remark Code N182 indicates that the claim/service must be billed according to the schedule for this plan. The official description states: ‘This claim/service must be billed according to the schedule for this plan.’ This means that the billing for the specific claim or service needs to align with the predetermined schedule set by the insurance plan. It is important to carefully review the plan’s guidelines and billing requirements to ensure compliance and avoid any potential issues.

2. Common Reasons

1. Incorrect billing codes: One common reason for Remark Code N182 is using incorrect billing codes that do not match the schedule for the plan. It is essential to accurately assign the appropriate codes to ensure proper billing.
2. Failure to follow plan-specific guidelines: Each insurance plan may have its own set of guidelines and requirements for billing. Not adhering to these guidelines can result in Remark Code N182.
3. Missing or incomplete documentation: Insufficient or incomplete documentation can lead to claim denials or adjustments. It is crucial to provide all necessary documentation to support the billed claim or service.
4. Non-compliance with pre-authorization requirements: Some insurance plans may require pre-authorization for certain services or procedures. Failing to obtain the necessary pre-authorization can result in Remark Code N182.

3. Next Steps

1. Review the insurance plan’s billing schedule: Carefully examine the plan’s guidelines and billing schedule to ensure accurate billing.
2. Verify the correct billing codes: Double-check that the assigned billing codes align with the plan’s schedule and requirements.
3. Ensure complete and accurate documentation: Provide all necessary documentation to support the billed claim or service, ensuring it meets the plan’s requirements.
4. Follow pre-authorization procedures: If pre-authorization is required, make sure to obtain the necessary approval before providing the service or procedure.

4. How To Avoid It

1. Stay updated on plan-specific guidelines: Regularly review and familiarize yourself with the billing guidelines and requirements of the insurance plans you work with.
2. Use accurate and up-to-date billing codes: Ensure that the assigned billing codes are current and align with the plan’s schedule.
3. Provide complete and thorough documentation: Submit all necessary documentation to support the billed claim or service, ensuring it meets the plan’s requirements.
4. Adhere to pre-authorization requirements: If pre-authorization is necessary, make sure to obtain the required approval before providing the service or procedure.

5. Example Cases

1. Case 1: A claim for a specific medical procedure is denied because it was billed using incorrect codes that do not match the plan’s schedule. This highlights the importance of using accurate billing codes.
2. Case 2: A claim adjustment occurs because the documentation provided for a particular service was incomplete, leading to Remark Code N182. This emphasizes the significance of providing complete and thorough documentation.

Source: Remittance Advice Remark Codes