Reason Code 151 | Remark Code N115 - JD DME
Reason Code 151 | Remark Code N115
|Reason Code: 151||Payment adjusted because the payer deems the information submitted does not support this many/frequency of services.|
|Remark Code: N115||This decision was based on a Local Coverage Determination (LCD).|
Common Reasons for Denial
- There is a date span overlap or overutilization based on related LCD.
- To adjust date span based on medical records available to supplier, suppliers may do a self service reopening in the Noridian Medicare Portal
- A Redetermination request may be submitted with all relevant supporting documentation. 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.
How to Avoid Future Denials
- To avoid overlap, review previous claim submissions and date spans
- For frequency guidelines, refer to applicable Local Coverage Determination (LCD), LCD Policy Article
- Prior to providing equipment, an Advance Beneficiary Notice of Noncoverage (ABN) may be obtained for items a supplier knows a beneficiary does not qualify for
- The Noridian Medicare Portal can be accessed under Same or Similar , option 2, to verify if beneficiary has had same or similar item or call the Noridian Interactive Voice Response (IVR) System at 866-419-9458 for Same or Similar
Last Updated Mon, 21 Dec 2020 22:14:22 +0000