N809Remark Code (RARC)ActiveInformational Alert
N809 Remark Code - Fee Schedule Adjusted for Bidding
The N809 remark code indicates that the fee schedule amount for the billed service has been adjusted due to prior competitive bidding rates. This adjustment is not tied to a specific claim denial or adjustment, serving as an informational alert for the provider.
What This Alert Tells You
The N809 alert is informational and typically appears alongside other reason codes that might detail service adjustments or payment amounts. It signifies that the billed amount has been influenced by competitive bidding results, but does not indicate a denial or require corrective action.
Common Scenarios
1A provider submitted a claim for durable medical equipment (DME) services, and the remittance advice returned with the N809 alert.
→ The N809 remark informs the provider that the payment amount for the DME service has been adjusted according to competitive bidding rates, not due to any errors or denials in the claim.
2A claim for outpatient therapy services was billed, and the provider received an 835 with the N809 alert noted.
→ The N809 alert indicates that the payment for the outpatient therapy service was adjusted based on competitive bidding rates, signaling to the provider that this is a standard adjustment rather than an issue with the claim.
3After billing for a surgical procedure, a provider receives an 835 that includes the N809 alert.
→ The presence of the N809 remark means that the fee for the surgical procedure has been adjusted in line with competitive bidding rates, providing the provider with context for the payment received.
What to Do
- Do not take any corrective action based on the N809 alert, as it is informational only.
- If further clarification is needed, consider contacting your local contractor for detailed information on competitive bidding rates.
What to Check
- Review the competitive bidding documentation related to the service billed.
- Check the fee schedule for adjustments based on competitive bidding.
- Consult the provider's local contractor for specific policies or guidelines regarding fee adjustments.