N852Remark Code (RARC)Active
N852 Remark Code - Provider TIN Mismatch Explanation
The N852 remark code indicates that there is a discrepancy between the tax identification numbers (TINs) for the pay-to provider and the rendering provider. This remark supplements an adjustment already described by an accompanying reason code, clarifying that the mismatch in TINs is the cause for the adjustment.
How It Relates to the Denial
Typically, the N852 remark accompanies reason codes related to payment adjustments where provider identification issues are present. This combination signals to the biller that the adjustment is due to inconsistencies in provider identification information on the claim.
Common Scenarios
1A claim was submitted for a surgical procedure performed by Dr. Smith, but the remittance shows a payment adjustment due to provider identification issues.
→ The N852 remark suggests that Dr. Smith's TIN does not match the TIN on file for the facility where the procedure was billed. The payer expects this discrepancy to be resolved.
2A mental health service claim was filed, and the remittance advises of a partial payment with the N852 remark included.
→ In this case, the N852 indicates that the TIN for the rendering therapist does not align with the TIN for the billing entity, which may have led to the reduction in payment.
3A physical therapy claim was denied with a reason code for payment adjustment, and the N852 remark was added to the remittance advice.
→ The presence of the N852 remark points to a mismatch between the TINs of the therapist who provided the service and the clinic that billed for the service, directing the biller to investigate the TINs.
What to Do
- Verify that the TIN for the rendering provider matches the TIN for the pay-to provider as listed in your records.
- If discrepancies exist, correct the TIN information on the claim and resubmit it to the payer.
- Ensure that all provider enrollment documents reflect the correct TINs for both providers.
What to Check
- The claim submission records to confirm the TINs used for both the rendering and pay-to providers.
- The provider enrollment documents to verify the accuracy of the TINs on file with the payer.
- The remittance advice details for any additional notes or reason codes that may provide further context to the adjustment.