Reason Code 50 | Remark Code N180 - JD DME
Reason Code 50 | Remark Code N180
|Reason Code: 50||These are non-covered services because this is not deemed a 'medical necessity' by the payer.|
|Remark Code: N180||This item or service does not meet the criteria for the category under which it was billed.|
Common Reasons for Denial
- Claim is missing a Certificate of Medical Necessity or DME Information Form.
- Claim is missing the KX modifier.
- This is not a service covered by Medicare.
- If the remittance advice reason includes MA130, correct claim and rebill
- If CMN/DIF was submitted with claim, 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.
- If the KX modifier was omitted by mistake, request a Redeterminations/Appeals to add, change, or remove the KX (the same is true for GA, GZ, GY modifiers). Be sure to include all the appropriate documentation.
How to Avoid Future Denials
- Check applicable Local Coverage Determination (LCD), LCD Policy Article, and Documentation Checklists prior to billing
- Utilize the Noridian Modifier Lookup Tool to ensure proper modifiers are included on claim
Last Updated Thu, 10 Dec 2020 15:08:19 +0000