N552Remark Code (RARC)Active
N552 Remark Code - Payment Adjusted for Withhold Reversal
The N552 remark code indicates that the payment has been adjusted to reverse a previous withhold or bonus amount. This typically means that an amount previously withheld from payment has been returned to the provider's payment for the current claim.
How It Relates to the Denial
The N552 remark code usually accompanies adjustment reason codes that signal a payment adjustment related to a previously withheld amount. This combination suggests that the payer is rectifying an earlier decision regarding payment withholdings, impacting the overall payment amount.
Common Scenarios
1A provider submitted a claim for a surgical procedure, and the remittance advises that a portion of the payment has been adjusted due to a previous withhold on that claim.
→ In this case, the N552 remark code clarifies that the payer has reversed the earlier withholding, indicating the provider will receive the previously withheld amount.
2An outpatient service claim was processed, and the remittance statement shows a payment adjustment alongside a reason code indicating a bonus was previously withheld.
→ Here, the N552 remark code explains that the bonus amount previously deducted is now being returned to the provider, affecting the total payment for this claim.
3A provider receives an 835 for a patient visit that reflects an adjustment related to a prior withhold from a bundled payment.
→ The presence of the N552 remark code signifies that the payer has reversed the withholding from the bundled payment, clarifying the adjustment made to the claim.
What to Do
- Review the adjustment reason code accompanying the N552 to understand the context of the withhold or bonus reversal.
- Confirm that the payment amount reflects the adjustments indicated by the N552 remark code and the corresponding reason code.
What to Check
- The original claim submission to validate the initial withhold or bonus amount.
- The payer's remittance advice to ensure the adjustments are accurately reflected in the payment details.
- Any related correspondence or documentation from the payer regarding the withhold or bonus policy.