N688Remark Code (RARC)ActiveInformational Alert
N688 Remark Code - Medical Review Reversal Alert
The N688 remark code indicates that a claim reversal has occurred because of a medical or utilization review decision. This alert serves as a notification to the biller that the claim in question has been reversed, but it does not specify an adjustment or denial to address.
What This Alert Tells You
The N688 remark is informational and will appear alongside claim reversals, signaling that the reversal is related to a review process. It is not linked to any specific adjustment or reason code.
Common Scenarios
1A provider submits a claim for a surgical procedure, and later receives a remittance that includes the N688 remark.
→ In this case, the N688 remark indicates that the claim was reversed due to a decision made during a medical or utilization review, prompting the provider to consider the review's outcome.
2A facility bills for a series of outpatient services, and an ERA shows the N688 remark next to a reversal of payment for one of those services.
→ The N688 remark suggests that the payment reversal was influenced by a review process, indicating that the service may not have met necessary criteria.
3A claim for a diagnostic test is submitted, and the biller later sees the N688 remark on the 835 remittance indicating a reversal.
→ The N688 remark signals that the reversal is tied to a medical review decision, and the biller should investigate the review's findings.
What to Do
- Do not take any immediate action on the claim; the N688 is purely informational.
- Monitor future remittances for additional details regarding the review outcome.
- Be prepared to provide any necessary documentation if requested by the payer regarding the review.
What to Check
- Review the claim details to understand what service was reversed.
- Check the medical or utilization review documentation for insights into the decision.
- Look for any communication from the payer regarding the review that led to the reversal.