N574Remark Code (RARC)Active
N574 Remark Code - Provider Specialty Issue
The N574 remark code indicates that the payer's records show the ordering or referring provider is of a type or specialty that is not authorized to order or refer services. This code suggests that there may be an issue with the accuracy of the provider information submitted on the claim.
How It Relates to the Denial
The N574 remark code typically accompanies a claim adjustment reason code that indicates a denial or reduction related to the ordering or referring provider's qualifications. This combination signals that the claim cannot be processed due to provider ineligibility to order or refer the billed services.
Common Scenarios
1A claim for a diagnostic imaging service was submitted with an ordering provider who is a physical therapist.
→ The N574 remark code indicates that the physical therapist is not authorized to order the imaging service, prompting a review of the provider's credentials.
2A referral for a specialist visit was billed with the referring provider listed as a chiropractor.
→ The N574 remark code points out that chiropractors cannot refer patients for certain specialty services, suggesting the need to verify the referring provider's eligibility.
3A laboratory test claim was submitted with an ordering provider who is a naturopathic physician.
→ The N574 remark code indicates that naturopathic physicians may not have the authority to order specific lab tests, necessitating a check of the provider's qualifications.
What to Do
- Verify the accuracy of the ordering or referring provider information on the claim.
- Confirm that the provider is of a specialty that is allowed to order or refer the billed services.
- Contact the ordering or referring provider to ensure their credentials are up to date.
What to Check
- The claim submission details for the ordering/referring provider's specialty.
- The eligibility and credentialing records for the ordering/referring provider.
- The payer's guidelines regarding which provider types can order or refer specific services.