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Reason Code 173 | Remark Code N668 - JD DME

Reason Code 173 | Remark Code N668

Code Description
Reason Code: 173 Service/equipment was not prescribed by a physician.
Remark Code: N668 Incomplete/invalid prescription.


Common Reasons for Denial

  • An initial Certificate of Medical Necessity (CMN) or DME Information Form (DIF) was not submitted with claim or 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
  • 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
  • If an initial CMN or DIF is posted to Common Working File (CWF) under another jurisdiction, include a comment on claim
  • Ensure all the front end acknowledgement reports from the electronic transmission with CEDI are worked by supplier staff or clearinghouse, to ensure the CMN/DIF is put on file


Last Updated Mon, 27 Mar 2023 13:50:40 +0000