N162Remark Code (RARC)ActiveInformational Alert
N162 Remark Code - Laboratory Certification Alert
The N162 remark code serves as an alert indicating that while your claim was paid, the billed test or specialty is not included in your laboratory certification. This serves as a warning that failure to correct the laboratory certification information could lead to a denial of payment in future claims.
What This Alert Tells You
The N162 alert is informational and typically appears alongside paid claims where the services rendered may not align with the laboratory's certified capabilities. It is not tied to any specific adjustment or denial but serves as a proactive notice to the billing office.
Common Scenarios
1A lab billed for a specialized test that was performed, but the claim was processed and paid without issue.
→ The N162 alert is indicating that although the claim was paid, the test performed is outside the scope of the laboratory's certification, suggesting a need for review.
2A provider submitted a claim for a new type of laboratory test, which was paid, but later received the N162 remark on the remittance advice.
→ The N162 remark warns that the laboratory certification does not cover the billed test, hinting that future claims for this test may not be paid if corrections are not made.
3A lab received payment for routine tests but billed for a specialty test that was not certified, prompting the N162 alert on the remittance advice.
→ The N162 alert informs the lab that while payment was received, the lack of certification for the specialty test must be addressed to avoid future payment denials.
What to Do
- Review your laboratory certification details to ensure all billed tests are included.
- Contact the certifying body to update or correct your laboratory certification as needed.
What to Check
- The laboratory certification documentation to verify the tests covered.
- The claim details to ensure accurate billing practices are being followed.
- Payer guidelines regarding laboratory certifications and billing requirements.