How To Fix Remark Code M950 (RARC) | Common Reasons, Next Steps & How To Avoid It

Remark Code N752 means that there is a missing, incomplete, or invalid HIPPS Treatment Authorization Code (TAC). This code is used to indicate the reason for denial or adjustment of a claim related to the HIPPS TAC. Understanding this code is crucial for medical coders and healthcare providers to ensure accurate billing and reimbursement.

1. Description

Remark Code N752 signifies that there is a missing, incomplete, or invalid HIPPS Treatment Authorization Code (TAC). The official description states: ‘Missing/incomplete/invalid HIPPS Treatment Authorization Code (TAC).’ The HIPPS TAC is an essential component of the billing process, as it provides information about the specific treatment authorized for a patient. Without a valid TAC, claims may be denied or adjusted, leading to potential financial implications for healthcare providers.

2. Common Reasons

1. Missing HIPPS TAC: This occurs when the required HIPPS TAC is not provided in the claim submission. It is crucial to include the TAC to ensure accurate billing and reimbursement.
2. Incomplete HIPPS TAC: An incomplete TAC may be missing certain elements or contain errors, making it invalid for billing purposes. It is essential to double-check the TAC for accuracy and completeness.
3. Invalid HIPPS TAC: An invalid TAC may be one that does not match the patient’s authorized treatment or is not recognized by the payer. It is important to ensure that the TAC is valid and aligns with the authorized services.

3. Next Steps

1. Review the claim for missing or incomplete HIPPS TAC: Carefully examine the claim to identify any missing or incomplete TAC information. If necessary, reach out to the responsible party to obtain the correct TAC.
2. Verify the accuracy of the HIPPS TAC: Cross-reference the TAC provided with the authorized treatment to ensure they align. If any discrepancies are found, correct the TAC before resubmitting the claim.
3. Communicate with the payer or responsible party: If there are any questions or concerns regarding the HIPPS TAC, contact the payer or responsible party to clarify any issues and obtain the necessary information.

4. How To Avoid It

1. Ensure the HIPPS TAC is included in the claim: Double-check that the HIPPS TAC is accurately entered in the claim submission. This step helps prevent denials or adjustments due to missing TAC information.
2. Verify the completeness and accuracy of the HIPPS TAC: Review the TAC for any missing elements or errors. Ensure that the TAC reflects the authorized treatment and is valid for billing purposes.
3. Stay updated on payer requirements: Familiarize yourself with the specific requirements of each payer regarding the HIPPS TAC. This knowledge helps ensure compliance and reduces the likelihood of claim issues.

5. Example Cases

1. Case 1: A claim is denied because the HIPPS TAC is missing, highlighting the importance of including the TAC in the claim submission.
2. Case 2: A claim adjustment occurs due to an invalid HIPPS TAC, emphasizing the need for accurate and valid TAC information.

Source: Remittance Advice Remark Codes