N795Remark Code (RARC)Active
N795 Remark Code - Resubmit as Purchase
The N795 remark code indicates that the billed item needs to be resubmitted as a purchase. This typically means that the payer requires the item to be classified differently in order to process the claim correctly.
How It Relates to the Denial
The N795 remark code often accompanies claim adjustment reason codes that indicate a denial or adjustment related to the classification of the billed service or item. Together, they signal that the claim was not processed due to the need for a different submission type.
Common Scenarios
1A provider submitted a claim for a medical device but received a denial indicating it was not covered. The remittance includes the N795 remark code.
→ In this case, the payer is indicating that the medical device needs to be resubmitted as a purchase item, rather than as a service or rental, to meet their processing requirements.
2A pharmacy billed for a prescription medication and received an adjustment on the remittance advice. The N795 remark code appeared alongside the adjustment reason code.
→ This suggests that the pharmacy needs to refile the claim as a purchase rather than a service to ensure proper reimbursement for the medication.
3A durable medical equipment supplier submitted a claim for a piece of equipment but got a partial payment. The remittance included the N795 remark code.
→ Here, the N795 remark code indicates that the claim for the equipment must be resubmitted as a purchase to align with the payer's processing guidelines.
What to Do
- Resubmit the claim indicating the item as a purchase rather than a service or rental.
- Ensure that all related documentation reflects the new classification as a purchase.
- Review the claim details to confirm that the item meets the criteria for purchase submission.
What to Check
- The original claim submission to verify how the item was classified.
- The accompanying reason code on the remittance for additional context.
- Payer guidelines regarding the classification of items for claims processing.