Reason Code 97 | Remark Code N390

Code Description
Reason Code: 97 The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Remark Code: N390 This service/report cannot be billed separately.

 

Common Reasons for Denial

  • HCPCS billed is included in payment/allowance for another service/procedure that was already adjudicated

Next Step

  • A Redetermination request may be submitted with all relevant supporting documentation. Review applicable Local Coverage Determination (LCD), LCD Policy Article, and documentation checklists prior to submitting request. Noridian encourages redeterminations be submitted using the Noridian Medicare Portal

How to Avoid Future Denials

  • Refer to applicable LCD and Policy Article to determine whether the HCPCS code is included in another service
  • Payment for both oxygen contents used with stationary oxygen equipment and oxygen contents used with portable oxygen equipment is included in the 36 monthly payments for oxygen equipment HCPCS E0424, E0439, E1390, or E1391. Before submitting claim for contents, verify stationary or portable oxygen equipment has met all 36 rental month payments
  • To verify number of oxygen rental payments, call Noridian Interactive Voice Response (IVR) as it accesses beneficiary's local and national file to determine same or similar equipment

 

Last Updated Apr 18, 2018