How To Fix Remark Code M973 (RARC) | Common Reasons, Next Steps & How To Avoid It

Remark Code N775 means that the payment has been adjusted based on an x-ray radiograph on film. This code is used to indicate the reason for the adjustment or denial of a claim related to x-ray services. Understanding this remark code is crucial for medical coders and healthcare providers to ensure accurate billing and reimbursement.

1. Description

Remark Code N775 indicates that the payment has been adjusted based on an x-ray radiograph on film. The official description states: ‘Payment adjusted based on x-ray radiograph on film.’ This remark code is typically used when the payment for an x-ray service is modified due to specific circumstances related to the radiograph on film.

2. Common Reasons

1. Outdated technology: One common reason for Remark Code N775 is the use of outdated technology, such as using film-based x-ray radiographs instead of digital imaging. Insurance companies may adjust the payment if they consider film-based radiographs to be less efficient or cost-effective.
2. Incomplete or illegible radiographs: If the x-ray radiograph on film is incomplete or illegible, it may lead to payment adjustments. Clear and comprehensive radiographs are essential for accurate diagnosis and treatment planning.
3. Non-standardized radiograph format: Some insurance companies may have specific requirements for the format or quality of x-ray radiographs. If the radiograph does not meet these standards, the payment may be adjusted.
4. Unnecessary or excessive x-ray imaging: If multiple x-ray radiographs on film are performed without a valid medical reason, the payment may be adjusted. Insurance companies often scrutinize the necessity and frequency of x-ray imaging to control costs.

3. Next Steps

1. Upgrade to digital imaging: Consider transitioning from film-based radiographs to digital imaging systems. Digital imaging offers numerous advantages, including improved image quality, faster processing, and easier storage and retrieval.
2. Ensure complete and legible radiographs: Train radiology staff to capture comprehensive and clear radiographs. Implement quality control measures to review and verify the quality of radiographs before submitting claims.
3. Adhere to insurance company requirements: Familiarize yourself with the specific requirements of insurance companies regarding radiograph formats. Ensure that the radiographs meet these standards to avoid payment adjustments.
4. Follow evidence-based guidelines: Only order x-ray imaging when medically necessary and supported by evidence-based guidelines. Avoid unnecessary or excessive x-ray imaging to minimize the risk of payment adjustments.

4. How To Avoid It

1. Invest in modern imaging technology: Consider upgrading to digital radiography systems to improve image quality and streamline the imaging process.
2. Train and educate radiology staff: Provide comprehensive training to radiology staff on capturing complete and legible radiographs. Emphasize the importance of quality control and adherence to imaging protocols.
3. Stay updated with insurance requirements: Regularly review the requirements of insurance companies regarding radiograph formats. Ensure that your facility meets these requirements to avoid payment adjustments.
4. Follow appropriate utilization guidelines: Familiarize yourself with evidence-based guidelines for ordering x-ray imaging. Only order x-rays when medically necessary and avoid excessive or unnecessary imaging.

5. Example Cases

1. Case 1: A claim for x-ray services is adjusted because the radiograph on film was incomplete, highlighting the importance of capturing comprehensive images for accurate billing.
2. Case 2: The payment for an x-ray service is reduced due to the use of outdated film-based radiographs instead of digital imaging, emphasizing the need to upgrade to modern technology.

Source: Remittance Advice Remark Codes