N664Remark Code (RARC)Active
N664 Remark Code - Adjusted Based on Legal Settlement
The N664 remark code indicates that the payment adjustment was made due to a legal settlement. This means that the payer has modified the billed amount based on an agreement reached in a legal context, which could involve a variety of factors specific to the case.
How It Relates to the Denial
The N664 remark code typically accompanies claim adjustment reason codes that relate to payment reductions or denials due to legal agreements. When seen together, these codes signal that the adjustment is not simply a standard billing issue but is influenced by legal considerations.
Common Scenarios
1A healthcare provider submits a claim for services rendered during a patient’s treatment, but the payment received is lower than expected with the N664 remark code attached.
→ In this scenario, the N664 remark suggests that the payment was reduced based on a legal settlement related to the claim, indicating that the amount billed was impacted by this legal context.
2A facility bills for a surgical procedure, and the remittance includes an adjustment with the N664 remark code, indicating a significant reduction in payment.
→ Here, the N664 remark implies that the facility's payment was adjusted due to a legal settlement, which may involve specific terms agreed upon regarding the claim.
3A provider receives a remittance for a series of outpatient services, with one line item adjusted down and marked with the N664 remark code.
→ This indicates that the adjustment for that particular service line is based on the outcomes of a legal settlement, affecting the payment received.
What to Do
- Review the legal documentation related to the settlement that may have impacted the payment.
- Ensure that any necessary adjustments to the billing reflect the outcomes of the legal settlement if applicable.
- Communicate with the payer if further clarification on the settlement's impact is needed.
What to Check
- The claim adjustment reason code that accompanies the N664 remark for additional context on the adjustment.
- Any legal agreements or settlement documents relevant to the claim in question.
- The billing records for the specific services rendered to ensure they align with the settlement details.