N471Remark Code (RARC)Active
N471 Remark Code - Missing HIPPS Rate Code Explained
The N471 remark code indicates that a HIPPS Rate Code is missing, incomplete, or invalid on the claim. This code supplements a Claim Adjustment Reason Code that has already addressed the adjustment, providing further clarification on the specific issue with the HIPPS Rate Code.
How It Relates to the Denial
The N471 remark typically accompanies adjustment reason codes related to reimbursement reductions or denials due to issues with the HIPPS Rate Code. It signals that the claim could not be processed correctly because the required HIPPS Rate Code was either not provided or was incorrect.
Common Scenarios
1A skilled nursing facility submits a claim for a patient stay but receives a payment denial with a reason code stating the claim was processed with an incorrect HIPPS Rate Code.
→ The presence of the N471 remark indicates that the payer found the HIPPS Rate Code on the claim to be missing or invalid, prompting the denial.
2A home health agency's claim for therapy services includes a HIPPS Rate Code, yet the remittance shows an adjustment for insufficient information regarding that code.
→ The N471 remark points out that the HIPPS Rate Code was not appropriately completed or validated, leading to the adjustment noted in the accompanying reason code.
3A rehabilitation facility submits a claim with a HIPPS Rate Code, but the remittance advises that the payment is reduced due to an invalid code.
→ The N471 remark clarifies that the payer could not accept the submitted HIPPS Rate Code, indicating it was either missing or did not meet their requirements.
What to Do
- Verify the submitted HIPPS Rate Code for accuracy and completeness.
- Correct any missing information or errors in the HIPPS Rate Code and prepare to resubmit the claim if applicable.
- Ensure that the HIPPS Rate Code aligns with the services provided and adheres to the payer's specifications.
What to Check
- Review the claim submission for the HIPPS Rate Code entry.
- Consult the payer's guidelines for valid HIPPS Rate Codes.
- Check the patient's record to confirm the correct HIPPS Rate Code based on the services rendered.