N186Remark Code (RARC)Active
N186 Remark Code - Non-Availability Statement Required
The N186 remark code indicates that a Non-Availability Statement (NAS) is required for the billed service. This suggests that the service may only be provided outside of the Military Treatment Facility (MTF) network, and the provider must obtain this statement to validate the claim.
How It Relates to the Denial
The N186 remark code typically accompanies adjustment reason codes related to claims being denied or reduced due to lack of required documentation. This combination signals that the payer requires additional proof of authorization for the service provided.
Common Scenarios
1A claim for outpatient surgery was submitted, but the payment was reduced with the accompanying reason code indicating the service is not covered without a NAS.
→ The N186 remark code is pointing out that the absence of a Non-Availability Statement has led to the adjustment. The payer expects this documentation to justify the service.
2A claim for physical therapy services at an off-base facility was denied, and the remittance included the adjustment reason code stating the service requires pre-authorization.
→ In this case, the N186 remark code indicates that a Non-Availability Statement is necessary to support the claim's eligibility, as services must be authorized when obtained outside the MTF.
3A provider billed for a specialized imaging service, but the claim was partially denied with a reason code indicating services must be provided within the MTF unless a NAS is presented.
→ The N186 remark code highlights that the payer requires the Non-Availability Statement to proceed with payment for the imaging service provided outside the MTF.
What to Do
- Obtain the Non-Availability Statement from the appropriate Military Treatment Facility.
- Submit the NAS along with the claim if resubmitting or appealing the adjustment.
- Ensure that future claims for similar services include the NAS documentation upfront.
What to Check
- Review the original claim submission for the missing Non-Availability Statement.
- Check the payer's guidelines regarding NAS requirements for the billed service.
- Examine any previous communications from the payer about the necessity of the NAS.