Reason Code 4 | Remark Code N519 - JA DME

Common Reasons for Denial

• Modifier used is inconsistent with HCPCS code.
• Modifier may be incorrect modifier for date of service on claim.
• May be incorrect capped rental modifier for date of service being billed.
• Modifier not required for HCPCS billed.

Next Step

• Correct claim line with appropriate required modifier(s) and resubmit claim

How to Avoid Future Denials

• Use appropriate modifiers per appropriate Local Coverage Determination (LCD), LCD Policy Article
• Utilize the Noridian Modifier Lookup Tool to ensure proper modifiers are included on claim
• Ensure correct capped rental modifier is appended for date of service billed.