N673Remark Code (RARC)Active
N673 Remark Code - Outpatient Reimbursement Explained
The N673 remark code indicates that the reimbursement for the billed services has been calculated using an outpatient per diem rate or an outpatient fee schedule amount. This code serves as a clarification for the adjustment noted by the accompanying reason code, highlighting the basis of the payment calculation.
How It Relates to the Denial
The N673 remark code typically accompanies a claim adjustment reason code that reflects a payment reduction based on the application of an outpatient per diem or fee schedule. Together, these codes signal that the reimbursement amount is determined by these specific payment methodologies, rather than the billed amount.
Common Scenarios
1A facility billed for a series of outpatient services, but the payment received was significantly lower than expected.
→ The N673 remark code indicates that the payment was calculated using an outpatient per diem rate, suggesting the facility's charges exceeded the allowable amount set by the payer's fee schedule.
2A provider submitted a claim for outpatient therapy sessions, and the remittance shows an adjustment with a lower payment than billed, accompanied by N673.
→ In this case, the N673 remark code explains that the reimbursement was based on an outpatient fee schedule, indicating that the payer adhered to their set rates for these services.
3After billing for a day of outpatient care, the provider received a remittance showing a payment adjustment with N673 included.
→ The N673 code informs the provider that the reimbursement was calculated according to an outpatient per diem rate, clarifying why the payment differs from the billed amount.
What to Do
- Review the accompanying claim adjustment reason code for details about the adjustment.
- Confirm that the billed services align with the outpatient per diem or fee schedule used for reimbursement.
- If necessary, consider appealing if the billed amount is justified based on the patient's treatment.
What to Check
- The fee schedule applicable to the outpatient services provided.
- The claim adjustment reason code that accompanies the N673 remark code.
- Documentation of the services rendered to ensure they align with the payer's billing guidelines.