N808Remark Code (RARC)Active
N808 Remark Code - Not Covered for Provider Type
The N808 remark code indicates that the service billed is not covered for the specific provider type or specialty. This means that the payer has determined that the provider is not eligible to perform the billed service under the current plan guidelines.
How It Relates to the Denial
The N808 remark typically accompanies a claim adjustment reason code that indicates denial due to provider type or specialty issues. The combination signals that the service is not reimbursable based on the provider's classification.
Common Scenarios
1A physical therapy claim was submitted by a chiropractor for a treatment session. The remittance returned with a denial indicating the service was not covered.
→ In this case, the N808 remark suggests that the chiropractor's specialty does not allow for reimbursement of physical therapy services, as per the payer's policy.
2An internist billed for a surgical procedure, but the claim was denied with a remark stating it is not covered for the provider specialty.
→ The N808 remark indicates that the internist's specialty does not align with the requirements for performing the surgical procedure, leading to the denial.
3A claim for a diagnostic imaging service was submitted by a nurse practitioner, which was denied with a note about provider type coverage.
→ The presence of the N808 remark indicates that the payer does not cover diagnostic imaging services provided by nurse practitioners, signaling a specialty-related denial.
What to Do
- Verify the provider's specialty designation in the billing system.
- Check the specific service billed to ensure it aligns with the provider's allowed services.
- Consult payer policies to confirm coverage parameters for the provider type.
What to Check
- The provider's specialty classification in your records.
- Payer's policy documents regarding service coverage by provider types.
- The claim adjustment reason code accompanying the N808 remark for further context.