N228Remark Code (RARC)Active
N228 Remark Code - Incomplete/Invalid Consent Form
The N228 remark code indicates that there is an incomplete or invalid consent form associated with the claim. This remark serves to clarify the reason for an adjustment previously specified by a Claim Adjustment Reason Code, highlighting issues with the consent documentation required for processing the claim.
How It Relates to the Denial
The N228 remark code typically accompanies adjustment reason codes related to claim denials or reductions due to documentation issues. This combination signals to the biller that the payer is rejecting the claim based on insufficient consent documentation rather than the service itself or other factors.
Common Scenarios
1A provider submits a claim for a procedure requiring patient consent, but the remittance comes back showing a denial for insufficient documentation.
→ In this case, the N228 remark code reinforces that the claim is being adjusted due to the absence or invalidity of the patient consent form that is necessary for the service billed.
2A claim for a mental health service is processed, but the remittance advises that the claim was denied due to an incomplete consent form.
→ Here, the N228 remark code points out that the payer found the consent form lacking essential information, which is critical for approving the claim.
3A facility bills for a surgical procedure, and the remittance report indicates an adjustment citing a consent issue.
→ The appearance of the N228 remark code means that the payer has flagged the claim for adjustment because the consent documentation did not meet their requirements.
What to Do
- Review the patient's consent form to ensure it is fully completed and valid.
- Resubmit the claim with the corrected or completed consent documentation attached.
- If necessary, contact the patient to obtain a valid consent form before resubmission.
What to Check
- The patient consent form for completeness and validity.
- The claim submission to confirm that all required documents were included.
- Any payer-specific guidelines regarding consent form requirements for the services billed.