N790Remark Code (RARC)Active
N790 Remark Code - Provider Not Accredited
The N790 remark code indicates that the provider or supplier is not accredited for the specific product or service billed. This remark supplements a claim adjustment reason code, clarifying that the lack of accreditation is the basis for the adjustment made by the payer.
How It Relates to the Denial
The N790 remark code typically accompanies adjustment reason codes related to provider credentialing issues. This combination signals that the claim has been adjusted due to the provider's inability to meet accreditation requirements for the billed services or products.
Common Scenarios
1A hospital bills for a new type of medical equipment used in a procedure, but the remittance shows a denial with the N790 remark code.
→ In this case, the N790 remark suggests that the hospital is not accredited to use or provide the specific equipment billed, leading to the denial.
2A durable medical equipment supplier submits a claim for a wheelchair, but the claim is adjusted with an accompanying N790 remark code.
→ Here, the N790 remark indicates that the supplier lacks the necessary accreditation to provide the wheelchair, which is why the claim was adjusted.
3A physician bills for a specialized service, and the remittance advises that the claim was denied with the N790 remark code present.
→ The presence of the N790 remark indicates that the physician is not accredited to perform the specialized service billed, prompting the denial.
What to Do
- Review the accreditation status of the provider or supplier for the specific product or service.
- Contact the accreditation body to determine the requirements and status for the provider or supplier.
- Consider resubmitting the claim only if the provider obtains the necessary accreditation.
What to Check
- The provider's accreditation documentation for the specific service or product.
- The claim adjustment reason code that accompanies the N790 remark.
- The payer's policy on provider accreditation for the billed services or products.