N87Remark Code (RARC)Active
N87 Remark Code - Home Use of Biofeedback Not Covered
The N87 remark code indicates that the home use of biofeedback therapy is not covered by the payer. This remark supplements an adjustment already explained by an accompanying reason code, clarifying that the specific service billed is ineligible for reimbursement.
How It Relates to the Denial
The N87 code typically accompanies adjustment reason codes related to non-covered services or benefits. When combined, they signal that the billed service was denied because it does not meet coverage criteria as defined by the payer's policy.
Common Scenarios
1A provider billed for biofeedback therapy provided to a patient at home, expecting coverage based on previous authorizations. The remittance advice shows a denial with the N87 remark code.
→ In this case, the N87 remark clarifies that the payer does not cover biofeedback therapy when it is conducted in a home setting, despite any prior authorizations.
2A claim for home-based biofeedback therapy was submitted, but the payment was denied with an adjustment reason code for non-covered services. The N87 remark appeared on the remittance advice.
→ The N87 remark confirms that the payer's policy explicitly excludes home use of biofeedback therapy, thus reinforcing the denial indicated by the adjustment reason code.
3A facility submitted a claim for biofeedback therapy done at home, and the remittance returned with an adjustment for a non-covered service along with the N87 remark code.
→ The N87 remark indicates that the service is not covered under the payer's benefits, emphasizing that home usage of biofeedback therapy does not qualify for reimbursement.
What to Do
- Review the patient's policy to confirm coverage details for biofeedback therapy.
- Consider alternative settings for therapy that may be covered, such as in-office visits.
- If applicable, communicate with the patient regarding their financial responsibility for the denied service.
What to Check
- The patient's plan benefit document for coverage specifics on biofeedback therapy.
- Any prior authorizations or approvals related to the therapy provided.
- The claim details to ensure the service was billed correctly according to provider guidelines.