N118Remark Code (RARC)Active
N118 Remark Code - Service Not Paid if Billed Too Often
The N118 remark code indicates that the billed service is not eligible for payment because it has been billed more than once within a 28-day period. This suggests that there are specific frequency limitations set by the payer for this type of service, which must be adhered to for reimbursement.
How It Relates to the Denial
The N118 remark code typically accompanies a Claim Adjustment Reason Code that indicates a denial or adjustment due to frequency limitations. Together, these codes signal that the service was either billed too frequently or outside of the allowed timeframe for reimbursement.
Common Scenarios
1A provider submitted a claim for a monthly physical therapy session and received a denial for the same service billed within 25 days of a previous claim.
→ The N118 remark code clarifies that the denial is due to the service being billed too frequently, as it exceeds the allowed once-per-28-days limit.
2A patient received a routine immunization, but the claim was denied when a second immunization was billed within a 20-day window.
→ The appearance of the N118 remark code indicates that the payer's policy restricts payment for this immunization service to once every 28 days, leading to the denial.
3A claim for a repeat laboratory test was submitted, but the remittance returned an adjustment for the service along with the N118 remark code.
→ In this case, the N118 remark code indicates that the laboratory test cannot be reimbursed because it was billed more than once in the allowed 28-day period.
What to Do
- Review the claim submission dates to confirm the frequency of the billed service.
- Adjust the billing to ensure that the same service is not submitted more than once within the 28-day limit.
- Consider rescheduling the service to comply with the payer's frequency policy.
What to Check
- The dates of previous claims for the same service to verify compliance with the 28-day rule.
- The payer's policy documents regarding service frequency limitations.
- The claim details to ensure accurate coding and billing of the service in question.