N179Remark Code (RARC)Active
N179 Remark Code - Additional Information Requested
The N179 remark code indicates that the payer has requested additional information from the member before they can proceed with the reconsideration of the charges. This remark is intended to inform the biller that the claim is currently on hold pending the requested information.
How It Relates to the Denial
The N179 code typically accompanies a Claim Adjustment Reason Code that reflects a denial or adjustment due to the need for more information. Together, they signal that the claim cannot be finalized until the payer receives the necessary documentation from the member.
Common Scenarios
1A provider submitted a claim for a diagnostic test, and the remittance shows a denial with a reason code indicating incomplete information.
→ The N179 remark suggests that the payer needs the member to provide further details about the test before they will reconsider the claim.
2A hospital billed for a surgical procedure, but the claim was adjusted due to missing pre-authorization documentation, as indicated by the accompanying reason code.
→ The appearance of the N179 remark means the payer is waiting for the member to submit the pre-authorization details to proceed with the claim.
3A claim for a physical therapy session was denied because the payer required additional documentation to support the medical necessity of the treatment.
→ The N179 remark indicates that the claim will remain in limbo until the member provides the requested documentation to the payer.
What to Do
- Follow up with the member to obtain the requested information.
- Submit the additional information to the payer as soon as it is available.
- Do not resubmit the claim until the requested details have been provided.
What to Check
- The member's response to the information request from the payer.
- The claim adjustment reason code on the remittance to understand the context of the N179 remark.
- Any documentation you have that may fulfill the payer's information request.