N351Remark Code (RARC)Active
N351 Remark Code - Service Date Outside Approved Treatment Plan
The N351 remark code indicates that the service date for a billed procedure falls outside the approved treatment plan service dates. This suggests that the payer has determined the service was not authorized during the specified timeframe of the treatment plan.
How It Relates to the Denial
The N351 remark typically accompanies adjustment reason codes related to denials based on authorization issues. Together, they signal that the billed service date does not align with what was approved in the treatment plan, leading to a denial or adjustment of the claim.
Common Scenarios
1A provider submits a claim for physical therapy services rendered on March 10, 2023, but the treatment plan only covers dates from February 1, 2023, to March 1, 2023. The remittance shows the N351 remark code.
→ In this scenario, the N351 remark indicates that the service date of March 10, 2023, is not covered because it falls outside the approved treatment plan timeframe.
2A claim for a follow-up appointment on April 15, 2023, is submitted, but the treatment plan authorized visits only through April 1, 2023. The N351 remark appears on the remittance advice.
→ Here, the N351 remark points out that the follow-up appointment date exceeds the limits of the authorized treatment plan, leading to a denial for that service.
3A claim for a diagnostic test performed on January 5, 2023, is denied due to the N351 remark, as the treatment plan only covered services from December 1, 2022, to December 31, 2022.
→ The N351 remark in this case indicates that the diagnostic test date is not covered because it occurred outside the authorized service dates of the treatment plan.
What to Do
- Review the service date on the claim to confirm it aligns with the treatment plan dates.
- Check the treatment plan documentation to verify the approved service dates.
- Consider resubmitting the claim with services that fall within the approved dates, if applicable.
What to Check
- The treatment plan documentation for authorized service dates.
- The claim submission date and the service date for discrepancies.
- Any additional notes or communications from the payer regarding the treatment plan.