N159Remark Code (RARC)Active
N159 Remark Code - Mileage Not Covered When Patient Not in Ambulance
The N159 remark code indicates that the payment for a claim has been denied or reduced because the billed mileage is not covered when the patient is not transported in the ambulance. This code supplements a corresponding Claim Adjustment Reason Code, adding clarity to the reason for the adjustment related to mileage billing.
How It Relates to the Denial
The N159 remark typically accompanies adjustment reason codes that denote denials or reductions in payment for ambulance services. It specifically signals that the issue lies with non-covered mileage when the patient was not in the ambulance during transport.
Common Scenarios
1A claim was submitted for an ambulance transport service, including a mileage charge for transporting a patient who was not in the vehicle.
→ The N159 remark indicates that the mileage billed is not eligible for payment because the patient was not present in the ambulance during the trip.
2An ambulance service billed for a transport that included additional mileage for a detour, but the patient was not in the ambulance for part of the trip.
→ The N159 remark suggests that the additional mileage is denied because it pertains to a segment where the patient was not in the ambulance, which is not covered.
3A bill was submitted for a round trip ambulance service, but a portion of the mileage was denied due to the patient not being in the ambulance for that leg of the trip.
→ The N159 remark clarifies that the denied mileage is not reimbursable since the patient was not in the ambulance during that specific segment.
What to Do
- Review the claim details to confirm that the patient was in the ambulance during the billed mileage.
- If the patient was in the ambulance, consider appealing the denial with supporting documentation that proves the patient's presence during transport.
What to Check
- The original claim submission to verify the details of the mileage billed.
- Patient transport documentation to confirm that the patient was present in the ambulance during the billed segments.
- The accompanying reason code on the remittance to understand the primary reason for denial or reduction.