N815Remark Code (RARC)Active
N815 Remark Code - Missing/Incomplete NDC Unit Count
The N815 remark code indicates that there is a missing, incomplete, or invalid National Drug Code (NDC) unit count associated with the billed service. This remark supplements a claim adjustment reason code by providing specific feedback on the NDC unit count, which is critical for accurate billing and processing of drug claims.
How It Relates to the Denial
The N815 remark code typically accompanies adjustment reason codes related to pharmaceutical claims, particularly those involving drug reimbursement. This combination signals that the unit count is a key factor for the payer's decision on the claim adjustment.
Common Scenarios
1A pharmacy submitted a claim for a medication that included an NDC but did not specify the unit count. The remittance shows an adjustment for the claim with the N815 remark code.
→ In this situation, the N815 remark indicates that the payer found the NDC unit count missing or invalid, which is necessary for proper processing of the drug claim.
2A provider billed for a prescription that included an NDC, but the unit count provided was zero. The remittance returned an adjustment along with the N815 remark code.
→ Here, the N815 remark is pointing out that the unit count is invalid, as it cannot be zero, thus affecting the reimbursement of the claim.
3A claim for a medication was submitted with an NDC, but the unit count was listed as a non-numeric value. The remittance response included an adjustment and the N815 remark code.
→ In this case, the N815 remark highlights that the unit count is invalid due to the non-numeric entry, indicating the need for correction before resubmission.
What to Do
- Verify that the NDC unit count is included in the claim submission.
- Ensure the NDC unit count is a valid numeric value and corresponds to the billed medication.
- If necessary, correct the unit count and resubmit the claim.
What to Check
- The original claim submission to confirm the NDC unit count provided.
- Payer guidelines for acceptable NDC unit counts and formats.
- Any previous communication from the payer regarding NDC requirements or adjustments.