N652Remark Code (RARC)Active
N652 Remark Code - Date of Service Before Date of Loss
The N652 remark code indicates that the date of service billed occurred prior to the date of loss. This suggests a potential issue with the timing of the services rendered in relation to the patient's coverage or eligibility period.
How It Relates to the Denial
The N652 remark typically accompanies a Claim Adjustment Reason Code that addresses adjustments related to coverage or eligibility issues. Together, these codes signal that the billed service is not eligible for payment due to the service date falling outside the allowed timeframe.
Common Scenarios
1A provider bills for a service rendered on June 1, 2023, but the patient's insurance coverage started on June 15, 2023. The remittance returns with a reason code indicating a denial due to eligibility.
→ The N652 remark clarifies that the service date is before the patient's coverage began, reinforcing the adjustment made by the accompanying reason code.
2A claim for physical therapy services dated February 20, 2023, is submitted, but the payer indicates a denial due to a lapse in coverage effective January 15, 2023.
→ The N652 remark points out that the service date is before the coverage loss date, which aligns with the reason for the adjustment in payment.
3A surgery performed on March 10, 2023, is denied by the payer with a reason code related to eligibility, and the N652 remark is included in the remittance advice.
→ The remark indicates that the date of service is earlier than when the patient was no longer eligible for coverage, thus explaining the denial.
What to Do
- Review the date of service in relation to the patient's coverage dates to confirm the eligibility status.
- If the date of service is indeed before the date of loss, no further action is needed as the denial is valid.
- If the coverage dates are incorrect, consider appealing the denial with the correct information.
What to Check
- The patient's eligibility records to confirm the coverage start and end dates.
- The claim submission date to ensure accurate service date alignment with coverage.
- The remittance advice details to verify the accompanying reason code for further context.