N799Remark Code (RARC)Active
N799 Remark Code - Individual Identifier Required
The N799 remark code indicates that the submitted identifier used for the claim must be an individual identifier rather than a group identifier. This suggests that the payer has detected a mismatch between the type of identifier submitted and what is required for processing the claim.
How It Relates to the Denial
This remark code typically accompanies a Claim Adjustment Reason Code that reflects an adjustment due to incorrect identifier usage. The combination signals that the payer requires clarification or correction regarding the identifier associated with the claim.
Common Scenarios
1A provider submitted a claim for a service rendered to a patient using a group NPI instead of the individual NPI of the treating physician. The remittance advises that the claim has been adjusted due to this identification issue.
→ In this scenario, the N799 remark code is indicating that the claim cannot be processed as billed because it did not include the appropriate individual identifier, which the payer requires.
2A claim for physical therapy services was submitted using a facility's group identifier. The remittance returned an adjustment with an accompanying N799 remark code, indicating an error in the identifier submitted.
→ Here, the N799 remark code highlights that the claim needs to reflect the individual therapist's identifier for proper processing, as the payer does not accept group identifiers for this service type.
3A claim for a surgical procedure was billed under a group practice name, but the insurance policy requires the individual surgeon's identifier. The remittance response included a denial with the N799 remark code.
→ The N799 remark code clarifies that the payer requires the individual surgeon's identifier to proceed with the claim, indicating that the group identifier is not acceptable in this case.
What to Do
- Review the claim submission to ensure an individual identifier is used instead of a group identifier.
- Resubmit the claim with the correct individual identifier associated with the provider who rendered the service.
What to Check
- Verify the submitted claim for the identifier type used (individual vs group).
- Check the provider's enrollment details to confirm the individual identifiers available.
- Review the payer's requirements for billing to ensure compliance with identifier usage.