N157Remark Code (RARC)Active
N157 Remark Code - Transportation Not Covered
The N157 remark code indicates that transportation to or from the specified destination is not covered under the payer's policies. This remark supplements a claim adjustment reason code that has already been provided, clarifying that the mode of transportation billed is not a covered service.
How It Relates to the Denial
Typically, the N157 remark accompanies adjustment reason codes related to transportation or non-covered services. The combination signals that while a claim was submitted for transportation, it was denied due to lack of coverage for the specific destination mentioned.
Common Scenarios
1A provider bills for non-emergency medical transportation to a specialist's office, but the claim is denied with a reason code indicating non-coverage.
→ The N157 remark clarifies that the trip to this destination is not covered, confirming the denial reason already provided.
2A patient is transported to a facility for a procedure, and the claim is submitted for reimbursement but returns with an adjustment for transportation services.
→ The presence of the N157 remark indicates that, according to the payer, transportation to this facility is not a covered benefit, aligning with the adjustment reason code issued.
3A claim for ambulance service to a hospital is submitted, but the remittance advises that the claim was adjusted due to the transportation being to a non-covered location.
→ The N157 remark reinforces that the specific destination of the ambulance transport is not covered under the payer's policy, as indicated by the accompanying adjustment reason code.
What to Do
- Review the claim details to ensure that the transportation service billed was necessary and appropriately coded.
- Verify if there are any alternative covered transportation options that could have been utilized.
- Consider appealing the decision if the transportation was required for a covered service.
What to Check
- The patient's insurance policy to confirm coverage details for transportation services.
- The claim submission to ensure proper coding for the transportation service provided.
- Any documentation that supports the medical necessity of the transportation to the billed destination.