N903Remark Code (RARC)Active
N903 Remark Code - Incomplete/Invalid Health Risk Assessment
The N903 remark code indicates that the health risk assessment (HRA) submitted with the claim is either incomplete or invalid. This remark supplements a Claim Adjustment Reason Code (CARC) that has already addressed an adjustment related to the HRA, providing additional context for the denial or adjustment.
How It Relates to the Denial
The N903 remark code typically accompanies adjustment reason codes that address issues with submitted health risk assessments. This combination signals that the payer is not processing the claim further due to the inadequacy of the HRA documentation.
Common Scenarios
1A provider submitted a claim for a preventive health service that included a health risk assessment. The remittance returned with a CARC indicating a denial due to a lack of required documentation.
→ The N903 remark code clarifies that the specific issue is with the health risk assessment being incomplete or invalid, which the payer requires for proper processing.
2A managed care organization denied a claim for a wellness visit, citing an adjustment reason code related to documentation issues. The remittance included N903 as a supplemental remark.
→ In this case, N903 indicates that the health risk assessment provided did not meet the payer's requirements, thus reinforcing the need for complete documentation.
3A facility billed for a comprehensive annual wellness visit but received a remittance with a CARC for documentation issues along with the N903 remark code.
→ This means the facility must address the specific deficiencies in the health risk assessment to resolve the claim denial.
What to Do
- Review the health risk assessment submitted for completeness and validity.
- Gather any additional documentation that may be required to support the HRA.
- Consider resubmitting the claim with the corrected or complete HRA.
What to Check
- The health risk assessment form submitted with the claim.
- The payer's specific requirements for HRAs as outlined in their policy documents.
- Any previous communications from the payer regarding HRA documentation issues.