N816Remark Code (RARC)Active
N816 Remark Code: Missing NDC Unit of Measure Explained
The N816 remark code indicates that there is a missing, incomplete, or invalid National Drug Code (NDC) unit of measure on the claim. This remark supplements a Claim Adjustment Reason Code, providing further details regarding the specifics of the NDC issue that has led to a payment adjustment.
How It Relates to the Denial
N816 typically accompanies adjustment reason codes that relate to drug billing discrepancies. The combination of this remark with the accompanying reason code signals that the payer has identified issues specifically with the NDC unit of measure, impacting reimbursement.
Common Scenarios
1A pharmacy submits a claim for a prescription medication, but the remittance advises that the payment was adjusted due to an issue with the NDC information provided.
→ The N816 remark indicates that the claim was denied or adjusted because the NDC unit of measure was missing, incomplete, or invalid, meaning the payer could not process the claim correctly.
2A provider bills for a drug administration service but receives a remittance that includes a payment adjustment with the N816 remark code.
→ This suggests that the NDC unit of measure for the drug administered was not accurately reported, prompting the payer to adjust the payment based on this discrepancy.
3An outpatient clinic submits claims for multiple medications, and one of the remittances shows the N816 remark associated with an adjustment reason code.
→ This indicates that at least one of the medications billed had issues with the NDC unit of measure, impacting the payment for that specific claim.
What to Do
- Review the claim to ensure the NDC unit of measure is correctly entered.
- Correct any missing or invalid NDC unit of measure and resubmit the claim if applicable.
- Verify that the NDC listed matches the unit of measure specified for the medication.
What to Check
- The original claim submitted for the NDC unit of measure details.
- The payer's NDC guidelines to confirm correct unit of measure formats.
- Any accompanying claim adjustment reason codes to understand the full context of the adjustment.