N718Remark Code (RARC)Active
N718 Remark Code: Missing Face-to-Face Examination Documentation
The N718 remark code indicates that the payer requires documentation proving a face-to-face examination took place but was not provided. This code supplements a Claim Adjustment Reason Code that signifies the adjustment made due to the lack of this documentation.
How It Relates to the Denial
N718 typically accompanies adjustment reason codes that relate to insufficient documentation or medical necessity. The combination signals that the claim was denied or adjusted due to missing required clinical information.
Common Scenarios
1A claim for an office visit was submitted, but the remittance shows an adjustment for insufficient documentation.
→ The N718 remark suggests that the payer is indicating a need for documentation of a face-to-face examination to support the billed services.
2A physical therapy claim was denied, and the remittance includes a reason code for medical necessity along with the N718 remark code.
→ This indicates that while the therapy may be deemed necessary, the lack of documentation for a face-to-face examination led to the denial or adjustment.
3A claim for a consultation service was processed, but the remittance reflects an adjustment for missing documentation, including the N718 remark code.
→ The N718 code informs the biller that a face-to-face examination was not documented as required, which contributed to the adjustment.
What to Do
- Obtain and submit the required documentation of the face-to-face examination if available.
- Review the original claim to ensure all necessary information was included before resubmission.
- Consider appealing the adjustment if you believe the documentation was submitted but not recognized.
What to Check
- The patient's medical record for documentation of the face-to-face examination.
- The original claim submission to confirm what was billed and what documentation was provided.
- The payer's specific documentation requirements for the service billed.