N427Remark Code (RARC)Active
N427 Remark Code - Payment for Eyeglasses or Contact Lenses
The N427 remark code indicates that the payment for eyeglasses or contact lenses is contingent upon the completion of cataract surgery. If this remark appears, it signals that the billed items cannot be reimbursed until the surgical procedure has occurred.
How It Relates to the Denial
Typically, N427 accompanies a claim adjustment reason code related to denied payment for eyeglasses or contact lenses. This combination indicates that the payer is enforcing a policy that ties the reimbursement of these items to prior cataract surgery.
Common Scenarios
1A patient had cataract surgery and then received a prescription for new eyeglasses, which were billed to the payer.
→ The N427 remark suggests that the eyeglasses cannot be paid until the cataract surgery is confirmed to have been completed, aligning with the payer's policy.
2An ophthalmologist billed for contact lenses following cataract surgery, but the claim was denied with a reason code and the N427 remark.
→ In this case, the N427 remark indicates the need for documentation confirming the cataract surgery before payment can be considered for the contact lenses.
3A claim for eyeglasses was submitted after cataract surgery, but the payment was denied with a corresponding reason code and the N427 remark present.
→ The N427 remark implies that the payer requires verification of the cataract surgery to proceed with payment for the eyeglasses.
What to Do
- Verify that cataract surgery has been performed before resubmitting claims for eyeglasses or contact lenses.
- Ensure that the claim submission includes documentation confirming the date of cataract surgery.
What to Check
- The patient's medical record to confirm the date of cataract surgery.
- The claim submission details to ensure that the correct procedure and items were billed appropriately.
- Any prior communications from the payer regarding policy on payment for eyeglasses or contact lenses after cataract surgery.