N551Remark Code (RARC)Active
N551 Remark Code - ASC Quality Reporting Adjustment
The N551 remark code indicates that the payment has been adjusted due to the Ambulatory Surgical Center (ASC) Quality Reporting Program. This remark supplements an adjustment already detailed by a Claim Adjustment Reason Code, providing additional context on the reason for the payment modification.
How It Relates to the Denial
The N551 remark code typically accompanies adjustment reason codes related to quality reporting for services provided in an ambulatory surgical center. The combination signals that the payment alteration is specifically linked to performance metrics or compliance with the ASC Quality Reporting Program.
Common Scenarios
1A facility submitted a claim for an outpatient surgical procedure performed at an ASC, and the payment received was lower than expected.
→ The N551 remark code suggests that the reduced payment is due to adjustments made under the ASC Quality Reporting Program, indicating that the facility's quality metrics may have influenced the reimbursement.
2A claim for a knee arthroscopy performed at an ASC was processed, showing an adjustment on the remittance advice.
→ The presence of the N551 remark code indicates that the adjustment relates to the ASC Quality Reporting Program, which affects how much is reimbursed based on reported quality measures.
3A provider received a remittance indicating a payment adjustment for a cataract surgery at an ASC, with an accompanying adjustment reason code on the remittance advice.
→ The N551 code clarifies that the adjustment was made in accordance with the ASC Quality Reporting Program, providing insight into the factors affecting the payment.
What to Do
- Review the adjustment reason code for details on the specific adjustment made to the payment.
- Ensure compliance with the ASC Quality Reporting Program by verifying that quality measures were accurately submitted and reported.
What to Check
- Check the claim submission details to confirm that quality reporting requirements were met.
- Review the ASC Quality Reporting Program documentation to understand the criteria affecting payment adjustments.
- Look at the remittance advice for the specific Claim Adjustment Reason Code that accompanies the N551 remark code.