N628Remark Code (RARC)Active
N628 Remark Code - Out-Patient Follow-Up Visits
The N628 remark code indicates that the payer disallows out-patient follow-up visits that occur on the same date of service as a scheduled test or treatment. This means that if a follow-up visit was billed alongside a scheduled procedure on the same day, the payer will not reimburse for the follow-up visit.
How It Relates to the Denial
The N628 remark code typically accompanies a claim adjustment reason code that reflects a denial for the follow-up visit. This combination signals that the billed service is not eligible for payment due to the overlapping nature of the scheduled test or treatment.
Common Scenarios
1A patient has a scheduled MRI on March 10 and also has a follow-up visit with the physician on the same day. The claim is submitted for both services.
→ In this case, the N628 remark code would indicate that the follow-up visit is not covered because it was billed on the same date as the MRI, which is a scheduled treatment.
2A patient receives physical therapy on January 5 and also has a follow-up consultation with their therapist on the same day. The claim for both services is processed.
→ Here, the N628 remark code signals that the follow-up consultation is disallowed because it occurs on the same date of service as the physical therapy.
3A patient undergoes a scheduled lab test on April 12 and then sees their doctor for a follow-up visit later that same day. Both services are submitted on the same claim.
→ The N628 remark code suggests that the follow-up visit is not reimbursable since it was performed on the same date as the scheduled lab test.
What to Do
- Verify that the follow-up visit was billed separately from the scheduled test or treatment.
- If appropriate, consider rescheduling the follow-up visit to a different date to ensure coverage.
- Review the claim adjustment reason code to understand the primary reason for the denial.
What to Check
- The claim details for the scheduled test or treatment to confirm the date of service.
- The follow-up visit claim to ensure it was billed correctly and on a separate date, if necessary.
- The payer's policy on outpatient services to understand their rules regarding same-day visits.