N513Remark Code (RARC)ActiveInformational Alert
N513 Remark Code - Initial Remit Alert for Claims
The N513 code indicates that this is the initial remittance for a non-NCPDP claim that was submitted in real-time and has undergone a change in its adjudication. This alert serves to inform billers that the claim has been processed for the first time, and that there may be updates or changes from the original submission.
What This Alert Tells You
As an informational alert, the N513 code does not accompany any specific adjustments or denial reason codes. Instead, it simply signals that there has been a change in the adjudication of a real-time submitted claim.
Common Scenarios
1A provider submits a non-NCPDP claim in real-time for a patient visit and later receives the initial remittance showing the N513 alert.
→ The N513 remark indicates that the claim has been adjudicated for the first time, and any changes from the original submission should be reviewed. The payer is alerting the provider to this initial processing.
2A facility bills for a surgical procedure using real-time submission and receives an 835 with the N513 remark on it.
→ Here, the N513 alert informs the facility that this is the first remittance for the surgical claim, and any alterations in adjudication should be taken into account for future billing practices.
3A provider receives an 835 for a non-NCPDP claim submitted in real-time, with the N513 remark present.
→ In this case, the N513 indicates that the claim has been processed for the first time and that there may be new adjudication details that differ from the original submission.
What to Do
- Do not take any specific action based on this alert, as it is informational only.
- Review the remittance details for any changes in adjudication that may affect future claims.
What to Check
- The details of the claim submission to understand the changes in adjudication.
- The remittance advice for any notes or explanations accompanying the N513 alert.
- Any internal records related to the claim to assess the impact of the initial adjudication change.