N557Remark Code (RARC)Active
N557 Remark Code - Service Area Not Payable
The N557 remark code indicates that the claim or service is not payable because it falls outside the payer's designated service area. It specifies that the claim should be filed with the payer or plan that covers the area where the specimen was collected.
How It Relates to the Denial
N557 typically accompanies claim adjustment reason codes related to geographical service area issues. This combination signals that the claim was processed but denied due to the location of service not being within the payer's coverage area.
Common Scenarios
1A laboratory billed for a specimen collection performed on a patient in a different state than the payer's service area.
→ The N557 remark code indicates that the payer will not cover the claim because the service was rendered outside of their service area, and the claim should be submitted to the appropriate payer for that location.
2A hospital submitted a claim for a diagnostic test done on a patient living in a region not covered by the payer's plan.
→ With the N557 remark present, it suggests that the hospital needs to redirect the claim to the payer that serves the area where the diagnostic test was performed.
3A physician's office filed a claim for a service provided to a patient who resides in a different geographical area than the payer's network.
→ The presence of the N557 remark code indicates that the claim is not payable under the current payer's policy, and it should be submitted to the appropriate payer who covers the patient's service area.
What to Do
- File the claim with the appropriate payer or plan that covers the area where the service was provided.
- Ensure the claim includes all necessary details regarding the service area for proper processing.
What to Check
- The patient's address to confirm their service area.
- The payer's policy on geographical coverage.
- The claim submission details to ensure correct billing information is provided.