N222Remark Code (RARC)Active
N222 Remark Code - Incomplete Admitting History Report
The N222 remark code indicates that the admitting history and physical report submitted with the claim is either incomplete or invalid. This remark supplements a claim adjustment reason code, providing additional clarity on why the claim may have been denied or adjusted due to issues with the documentation.
How It Relates to the Denial
The N222 remark typically accompanies claim adjustment reason codes related to documentation deficiencies or missing information. When this remark appears, it signals that the payer found the admitting history and physical report insufficient for processing the claim correctly.
Common Scenarios
1A hospital submits a claim for an inpatient admission, including the admitting history and physical report, but receives a denial indicating missing documentation.
→ The N222 remark suggests that the payer found the admitting history and physical report to be incomplete or invalid, which contributed to the denial.
2A provider submits a claim for a surgical procedure that requires a complete admitting history and physical report but receives an adjustment due to documentation issues.
→ The presence of the N222 remark indicates that the payer could not process the claim fully because the admitting history and physical report did not meet their requirements.
3An outpatient facility bills for a patient visit and includes an admitting history and physical report, but the remittance advises that there was an issue with the report.
→ The N222 remark points out that the admitting history and physical report was not adequate, leading to the adjustment of the claim.
What to Do
- Review the admitting history and physical report submitted with the claim.
- Ensure that all required information is included in the report as per payer guidelines.
- Correct any identified deficiencies and resubmit the claim with a complete report.
What to Check
- The admitting history and physical report for completeness and validity.
- Payer-specific requirements for what must be included in the admitting history and physical report.
- The claim adjustment reason code that accompanies the N222 remark for further context on the adjustment.