Reason Code 50 | Remark Code N161 - JA DME
Reason Code 50 | Remark Code N161
| Code | Description |
|---|---|
| Reason Code: 50 | These are non-covered services because this is not deemed a 'medical necessity' by the payer. |
| Remark Code: N161 | This drug/service/supply is covered only when the associated service is covered. |
Common Reasons for Denial
- This means that item provided is not covered because the base item this is used with is not covered
Next Step
- A Redetermination request may be submitted with all relevant supporting documentation. The medical necessity for the base item used with this accessory or supply must be included in the appeal. Noridian encourages Redeterminations/Appeals be submitted using the Noridian Medicare Portal. Review applicable Local Coverage Determination (LCD), LCD Policy Article, and Documentation Checklists prior to submitting request.
- Amounts may need to be adjusted off if documentation does not exist that base item for the accessory or supply is covered and an ABN was not obtained.
How to Avoid Future Denials
- Prior to providing item, an Advance Beneficiary Notice of Noncoverage (ABN) may be obtained for the accessory or supply if base item is not currently covered
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