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Reason Code 176 | Remark Code N592 - JD DME

Reason Code 176 | Remark Code N592

Code Description
Reason Code: 176 Prescription is not current.
Remark Code: N592 Adjusted because this is not the initial prescription or exceeds the amount allowed for the initial prescription.


Common Reasons for Denial

  • Recertified or revised Certificate of Medical Necessity (CMN) or DME Information Form (DIF) for item was not submitted or not on file with Noridian or
  • CMN is in denied status

Next Step

How to Avoid Future Denials

  • To verify a CMN or DIF is required, required for dates of service prior to January 1, 2023, refer to applicable Local Coverage Determination (LCD), LCD Policy Article
  • If an initial CMN/DIF is posted to Common Working File (CWF) under another jurisdiction, include a comment on claim narrative
  • For proper claims processing, attach initial CMN or DIF to claim, required for dates of service  prior to January 1, 2023
    • Supplier must submit initial CMN or DIF for item billed
  • Ensure that recert or revised CMN or DIF is transmitted.
  • Did your CMN/DIF get accepted when billed through the electronic transmission? If the front end acknowledgement reports from the electronic transmission with CEDI are not worked by supplier staff or clearinghouse, the CMD/DIF may not have been received by Noridian with the claim.


Last Updated Mon, 27 Mar 2023 13:46:37 +0000