N572Remark Code (RARC)Active
N572 Remark Code - Non-Payable Reporting Codes Required
The N572 remark code indicates that the billed procedure is not eligible for payment unless specific non-payable reporting codes and associated modifiers are included. This means the payer requires additional information related to the procedure before they will consider payment.
How It Relates to the Denial
The N572 remark code typically accompanies an adjustment reason code that indicates a denial due to non-compliance with reporting requirements. The combination suggests that the claim was denied specifically because the necessary codes or modifiers were not provided with the initial submission.
Common Scenarios
1A claim for a surgical procedure was submitted without the required non-payable reporting codes, and the remittance response included an adjustment reason code indicating denial for lack of documentation.
→ The N572 remark code clarifies that the denial is due to the absence of the necessary non-payable reporting codes and modifiers that are needed for this procedure.
2A therapy service claim was processed, but the remittance advised a denial reflecting an adjustment reason code for improper coding. The accompanying remark code was N572.
→ In this case, the N572 remark code points out that the procedure cannot be paid unless the appropriate non-payable reporting codes were included in the claim submission.
3A diagnostic imaging service was billed, and the remittance shows a denial with an adjustment reason code noting insufficient documentation. The N572 remark appears alongside it.
→ The N572 remark indicates that the claim was denied because the required non-payable reporting codes and modifiers were not submitted, which are necessary for review.
What to Do
- Review the claim submission for missing non-payable reporting codes and associated modifiers.
- Resubmit the claim with the appropriate codes and ensure all required modifiers are included.
What to Check
- The original claim submission for any missing non-payable reporting codes.
- Payer guidelines for the specific procedure to confirm required reporting codes and modifiers.
- The adjustment reason code that accompanies N572 for additional context on the denial.