N58Remark Code (RARC)Active
N58 Remark Code - Missing Patient Liability Amount
The N58 remark code indicates that there is a missing, incomplete, or invalid patient liability amount associated with the claim. This remark is meant to provide additional context regarding the adjustment noted by the accompanying reason code, clarifying that the patient’s financial responsibility is not accurately reflected in the claim.
How It Relates to the Denial
The N58 remark code typically accompanies adjustment reason codes related to underpayments or discrepancies in the billed amount. The combination signals that the payer has identified an issue with the patient liability amount that needs to be resolved for accurate processing.
Common Scenarios
1A hospital billed for a surgical procedure but received an adjustment indicating a payment reduction. The remittance included the N58 remark code.
→ In this scenario, the N58 remark suggests that the payer found the patient’s liability amount to be either missing or incorrectly stated, which affected the payment amount.
2A provider submitted claims for multiple visits, but one of the claims was denied with an adjustment and the N58 remark code attached.
→ This indicates that the claim was adjusted due to an issue with the reported patient liability, prompting a review of the claim details to ensure accuracy.
3A claim for a diagnostic test was processed, but the remittance included a payment adjustment with the N58 remark code indicating a problem with patient liability.
→ Here, the N58 remark highlights that the reported patient responsibility figure is invalid or incomplete, which needs to be corrected for proper reimbursement.
What to Do
- Review the claim for any errors in the reported patient liability amount.
- Ensure that the patient responsibility is accurately documented and matches the payer's expectations.
- If necessary, adjust the claim to reflect the correct patient liability and resubmit.
What to Check
- The claim submission details, particularly the patient liability section.
- The remittance advice for any accompanying reason codes that clarify the adjustment.
- The patient's insurance policy details to confirm their liability amounts.