N237Remark Code (RARC)Active
N237 Remark Code - Incomplete Patient Medical Record
The N237 remark code indicates that the patient medical record associated with the service billed is either incomplete or invalid. This remark supplements a claim adjustment reason code by clarifying that documentation issues are the reason for the adjustment.
How It Relates to the Denial
The N237 remark code typically accompanies adjustment reason codes that indicate a denial or reduction due to documentation deficiencies. This combination signals to the biller that the payer found issues with the medical record rather than the service itself being inappropriate or non-covered.
Common Scenarios
1A claim for a surgical procedure was submitted, but the remittance advice returned with a claim adjustment reason code indicating the claim was denied due to insufficient documentation.
→ The N237 remark code suggests that the patient’s medical record was either not complete or had inaccuracies, leading to the denial of the claim.
2A billing office submitted a claim for a diagnostic test but received a remittance with an adjustment reason code related to documentation errors.
→ The presence of the N237 remark code signifies that the payer found the patient’s medical record inadequate or invalid, which directly impacted the claims processing.
3A provider billed for a consultation service, and the remittance advised a reduction in payment due to documentation issues.
→ The N237 remark code indicates that the payer requires more complete or valid medical records to support the service billed, which may necessitate further action from the provider.
What to Do
- Review the patient medical record for completeness and accuracy.
- Gather any missing documentation that supports the service rendered.
- Ensure that the medical record aligns with the services billed to avoid future denials.
What to Check
- The patient medical record for the relevant service date.
- Any notes or documents that were submitted with the claim.
- The claim adjustment reason code that accompanies the N237 remark code for context.