How To Fix Remark Code M667 (RARC) | Common Reasons, Next Steps & How To Avoid It

Remark Code N460 means that there is an incomplete or invalid discharge summary. This code is used to indicate the reason for denial or adjustment of a claim related to discharge summary documentation.

1. Description

Remark Code N460 indicates that the discharge summary provided is either incomplete or invalid. The official description states: ‘Incomplete/invalid Discharge Summary.’ A discharge summary is a crucial document that provides a comprehensive overview of a patient’s hospital stay, including the reason for admission, treatment received, and recommendations for further care. An incomplete or invalid discharge summary can hinder accurate billing and impact the continuity of care for the patient.

2. Common Reasons

1. Incomplete discharge summary: This may occur when essential information is missing from the document, such as the patient’s medical history, treatment plan, or follow-up instructions.
2. Invalid discharge summary: An invalid discharge summary may contain inaccurate or conflicting information, making it unreliable for billing purposes or continuity of care.
3. Lack of required elements: Discharge summaries must include specific elements, such as the patient’s name, date of admission and discharge, attending physician’s name, and a summary of the patient’s condition and treatment received. Failure to include these elements can result in an incomplete or invalid discharge summary.
4. Missing signatures or authorizations: Discharge summaries often require signatures from the attending physician or other authorized healthcare professionals. If these signatures or authorizations are missing, the discharge summary may be considered incomplete or invalid.

3. Next Steps

1. Request a complete discharge summary: Contact the healthcare provider or facility to obtain the missing information or an updated discharge summary that includes all the required elements.
2. Verify the accuracy of the discharge summary: Review the document carefully to ensure that the information provided is correct and consistent. If there are any discrepancies or inaccuracies, communicate with the healthcare provider to rectify the issue.
3. Obtain necessary signatures or authorizations: If the discharge summary is missing required signatures or authorizations, work with the healthcare provider to obtain the necessary documentation.

4. How To Avoid It

1. Ensure comprehensive documentation: Healthcare providers should strive to create thorough and accurate discharge summaries that include all the required elements. This can be achieved through proper training and adherence to documentation guidelines.
2. Implement quality assurance processes: Establish protocols to review and verify the completeness and validity of discharge summaries before submitting claims. This can help identify and address any issues before they result in claim denials or adjustments.
3. Promote effective communication: Encourage open lines of communication between healthcare providers, ensuring that all necessary information is shared and documented appropriately.

5. Example Cases

1. Case 1: A claim for hospital services is denied because the discharge summary does not include the patient’s treatment plan and follow-up instructions, highlighting the importance of a complete discharge summary for accurate billing and continuity of care.
2. Case 2: A claim adjustment occurs because the discharge summary contains conflicting information regarding the patient’s condition, emphasizing the need for valid and reliable documentation.

Source: Remittance Advice Remark Codes