N667Remark Code (RARC)Active
Effective 07/15/2013 · Updated 03/14/2014

N667 Remark Code - Missing Prescription Explained

The N667 remark code indicates that a prescription is missing for the billed service. This suggests that the payer requires evidence of a valid prescription to process the claim correctly.

How It Relates to the Denial

The N667 remark code typically accompanies a claim adjustment reason code that indicates a denial or reduction due to insufficient documentation. It clarifies that the specific documentation lacking is the prescription itself.

Common Scenarios

1A provider submitted a claim for a medication but received a denial indicating insufficient documentation.
→ The N667 remark code indicates that the payer found no prescription included with the claim, which is necessary for approval.
2A claim for a durable medical equipment item was denied due to missing documentation, and the remittance included a reason code for insufficient documentation.
→ The N667 remark code specifies that the missing documentation is a prescription, which the payer expects to be provided to support the claim.
3A physical therapy service was billed without a prescription, and the remittance advised that the claim was denied due to missing supporting documents.
→ The presence of the N667 remark code highlights that a prescription is required to validate the service billed.

What to Do

  1. Obtain a copy of the missing prescription from the prescribing provider.
  2. Submit the prescription along with the original claim for reconsideration.
  3. Ensure future claims include all required documentation, including prescriptions.

What to Check

  • The original claim submission to confirm if a prescription was included.
  • The provider's records to verify that a prescription was issued for the service.
  • The payer's documentation requirements related to prescriptions for the billed service.