N107Remark Code (RARC)Active
N107 Remark Code - SNF Inpatient Billing Guidance
The N107 remark code indicates that services provided to inpatients of a Skilled Nursing Facility (SNF) must be billed as part of an inpatient claim. Billing these services separately as outpatient services is not permitted, which could lead to adjustments on the claim.
How It Relates to the Denial
The N107 remark code typically accompanies a claim adjustment reason code that reflects a denial or reduction due to improper billing of inpatient services. This combination signals that the payer expects these services to be included in the inpatient claim rather than billed separately.
Common Scenarios
1A facility submitted a claim for physical therapy services provided to a patient who was an inpatient at a Skilled Nursing Facility, but billed it as outpatient.
→ The N107 remark code suggests that the payer has adjusted the claim because these services should have been billed as part of the inpatient stay.
2A claim for nursing care services rendered to an SNF inpatient was denied after being submitted separately from the inpatient claim.
→ The presence of the N107 remark code indicates that the payer is clarifying that these services must be included in the inpatient billing, leading to the claim denial.
3A provider submitted a claim for lab tests performed on an SNF patient and received a remittance with an adjustment indicating that the claim was processed incorrectly.
→ The N107 remark code is highlighting that these lab tests must have been billed under the inpatient claim rather than as separate outpatient services.
What to Do
- Ensure that services rendered to SNF inpatients are included in the inpatient claim submission.
- Review the billing process to avoid submitting separate outpatient claims for inpatient services.
What to Check
- The inpatient claim submission for the patient to verify included services.
- The service dates and types billed to ensure they align with inpatient care guidelines.
- The payer's policy on billing for services rendered in Skilled Nursing Facilities.