Receiving Inpatient Denials with Reason Code 109, Remark Code N538 on your Remittance Advice

Are you receiving inpatient denials? Check out the exception to delivery rules when the beneficiary is in a Part A inpatient stay. Checking beneficiary eligibility, acceptable time of delivery, and billing the discharge date are key. For more information review the Standard Documentation Requirements for All claims Submitted to DME MACS and to assist in resolving denials and avoiding denials in the future, check out our Denial Code Resolution page on the Noridian Medicare website.

 

Last Updated Jun 30 , 2022