N622Remark Code (RARC)Active
N622 Remark Code - Not Covered Based on Date of Injury
The N622 remark code informs the biller that the claim is not covered due to the date of the injury or accident. This means that the services rendered may fall outside the coverage period established by the payer based on the specifics of the injury or accident date.
How It Relates to the Denial
The N622 code typically accompanies a claim adjustment reason code that indicates a denial based on coverage limitations or exclusions related to the date of service. The combination signals that the payer has determined the services are not eligible for reimbursement due to timing issues associated with the injury or accident.
Common Scenarios
1A provider submitted a claim for physical therapy services related to an accident that occurred over a year ago. The claim was denied on the remittance advice.
→ The N622 remark code indicates that the payer has determined the physical therapy services are not covered because they were billed after the allowable date following the accident.
2A patient received treatment for an injury sustained in a car accident, but the claim was submitted several months later. The remittance shows a denial with the N622 remark code.
→ The N622 remark is pointing out that the treatment date is not covered due to the elapsed time since the accident, suggesting the claim was submitted too late for coverage.
3An emergency room visit was billed for a patient who sustained an injury, but the claim received an adjustment with N622 noted on the remittance advice.
→ In this case, the N622 remark code indicates the payer does not cover the claim, as the date of service does not align with the coverage period related to the injury.
What to Do
- Verify the date of injury or accident against the service date billed.
- Check if the services rendered fall within the coverage period defined by the payer.
- Consider reviewing the patient's eligibility or coverage policy for further details on timing requirements.
What to Check
- The patient's medical record to confirm the date of injury or accident.
- The claim submission date to ensure compliance with the payer's timeline.
- The payer's policy documents regarding coverage limitations related to injury dates.