N601Remark Code (RARC)Active
N601 Remark Code - Payment Based on Hawaii RBRVS
The N601 code indicates that the payment determination is based on the Medicare Resource Based Relative Value Scale (RBRVS) system as it applies to Hawaii. This remark supplements a claim adjustment reason code by clarifying that the payment is aligned with Hawaii's Motor Vehicle Insurance Law guidelines.
How It Relates to the Denial
The N601 remark typically accompanies adjustment reason codes related to payment reductions or determinations that reference state-specific insurance laws. In this case, it signals that the payment methodology is influenced by local regulations and Medicare guidelines.
Common Scenarios
1A claim for a motor vehicle accident-related service was submitted, and the remittance reflects a payment amount lower than expected.
→ The N601 remark suggests that the payment amount is consistent with the Medicare RBRVS system as required by Hawaii law, indicating that the adjustment is not an error but a compliance issue.
2A provider billed for a service related to a motor vehicle injury, and the remittance shows an adjustment with a reason code for a payment reduction.
→ The presence of the N601 code clarifies that the payment reduction is in accordance with specific Hawaii regulations, and not due to a denial of service.
3A physical therapy claim related to a motor vehicle accident was processed, resulting in a payment that references the local insurance law.
→ The N601 remark indicates that the payment made is based on the RBRVS system as mandated by Hawaii's insurance regulations, providing context for the adjusted payment.
What to Do
- Confirm that the claim submitted complies with Hawaii's Motor Vehicle Insurance Law.
- Verify that the billed services align with the Medicare RBRVS guidelines applicable to Hawaii.
- If necessary, appeal the payment decision with supporting documentation showing compliance with state laws.
What to Check
- The claim adjustment reason code accompanying the N601 remark for further context.
- The Hawaii Administrative Rules, Title 16, Chapter 23 for specific regulations affecting payment.
- The original claim submission to ensure that the services billed are appropriate under the Medicare RBRVS system.