How To Fix Remark Code M921 (RARC) | Common Reasons, Next Steps & How To Avoid It
Remark Code N721 means that this service is only covered when performed as part of a clinical trial. This code is used to indicate that the claim has been denied or adjusted because the service was not performed within the context of a clinical trial.
1. Description
Remark Code N721 indicates that the specific service in question is only covered when it is performed as part of a clinical trial. The official description states: ‘This service is only covered when performed as part of a clinical trial.’ This means that if the service was not performed within the context of a clinical trial, the claim will be denied or adjusted accordingly.
2. Common Reasons
- The service was not performed as part of a clinical trial: The most common reason for Remark Code N721 is that the service was not conducted within the framework of a clinical trial. This could be due to a lack of proper documentation or failure to meet the specific criteria for clinical trial participation.
3. Next Steps
- Contact the healthcare provider for clarification: If you believe that the service should have been performed as part of a clinical trial, it is important to reach out to the healthcare provider for further information and clarification. They may be able to provide additional documentation or explanation to support your claim.
- Review the clinical trial criteria: Familiarize yourself with the specific criteria for clinical trial participation to ensure that the service in question meets the necessary requirements. This will help you determine if the claim denial or adjustment is valid or if there has been an error.
4. How To Avoid It
- Ensure the service is performed within a clinical trial: To avoid Remark Code N721, it is crucial to ensure that the service is conducted within the context of a clinical trial if coverage is expected. This may involve coordinating with the healthcare provider and confirming the eligibility criteria for participation in a clinical trial.
- Provide complete and accurate documentation: Proper documentation is essential to support the claim for coverage within a clinical trial. Make sure to provide all necessary documentation, including proof of participation in the trial and any other relevant information.
5. Example Cases
- Case 1: A claim for a specific service is denied because it was not performed as part of a clinical trial. Upon further investigation, it is discovered that the service was conducted outside of the clinical trial setting, leading to the denial.
- Case 2: A claim adjustment occurs because the necessary documentation proving the service was performed within a clinical trial is missing. The claim is adjusted until the required documentation is provided.
Source: Remittance Advice Remark Codes
