N776Remark Code (RARC)Active
N776 Remark Code - Not a Covered Telehealth Service
The N776 remark code indicates that the billed service is not considered a covered telehealth service by the payer. This remark supplements the associated Claim Adjustment Reason Code to clarify that the specific service provided does not qualify for telehealth reimbursement under the payer's policy.
How It Relates to the Denial
The N776 remark typically accompanies adjustment reason codes that indicate a denial for telehealth services. The combination signals that while a claim was submitted for a telehealth service, the payer does not recognize it as covered under their telehealth guidelines.
Common Scenarios
1A provider bills for a virtual consultation that includes a physical examination component. The remittance returns an adjustment reason code indicating denial for telehealth services.
→ In this case, the N776 remark clarifies that the specific service billed does not meet the payer's criteria for a covered telehealth service, leading to the denial.
2A mental health provider submits a claim for an online therapy session. The remittance shows an adjustment for non-covered services.
→ Here, the N776 remark indicates that the claim was denied because the service rendered is not recognized as a covered telehealth service by the payer.
3A patient receives a telehealth follow-up visit and the claim is denied with a reason code concerning telehealth coverage.
→ The N776 remark reinforces that the payer does not cover this type of telehealth service, thus explaining the denial.
What to Do
- Review the claim details to confirm the service is billed correctly as a telehealth service.
- Consider resubmitting the claim with a different service that is covered if applicable, or explore alternative billing options.
- Consult with the provider to determine if the service can be modified to meet telehealth coverage criteria.
What to Check
- The payer's telehealth coverage policy to understand which services are eligible for reimbursement.
- The specific service code billed to verify if it is listed as a covered telehealth service by the payer.
- The patient eligibility response to see if telehealth benefits were confirmed prior to service delivery.