N887Remark Code (RARC)Active
N887 Remark Code - Appeal Rights for Medicare Advantage
The N887 remark code informs providers that they have the right to appeal a payment denial from a Medicare Advantage Plan if they believe the payment was insufficient or incorrect. This code indicates that the appeal must be submitted in writing within 60 calendar days of the remittance advice date, along with a completed Waiver of Liability Statement.
How It Relates to the Denial
N887 is typically used alongside adjustment reason codes that indicate a denial or underpayment by the Medicare Advantage Plan. This combination signals that the provider can challenge the payer's decision if they believe the payment does not meet Medicare standards.
Common Scenarios
1A provider submits a claim for a service rendered to a Medicare Advantage patient, but the remittance shows a partial denial with an adjustment reason code indicating insufficient payment.
→ The N887 remark code signifies that the provider can appeal the denial if they feel the payment does not reflect the expected Medicare rates, provided they comply with the appeal process.
2A billing office receives a remittance indicating that a claim for a surgical procedure was denied due to non-participation in the Medicare Advantage Plan.
→ With the N887 remark present, the billing office understands that the provider can appeal this decision by submitting a written request and the necessary Waiver of Liability Statement.
3A provider receives a remittance showing that a diagnostic test claim was fully denied, and they believe it should have been reimbursed at the Medicare rate.
→ The presence of the N887 remark code indicates that the provider has the option to appeal the denial within the specified timeframe if they believe the payment was not adequate.
What to Do
- Prepare a written appeal addressing the denial, citing the N887 remark.
- Complete and sign the Waiver of Liability Statement to include with the appeal.
- Submit the appeal within 60 calendar days from the remittance advice date.
What to Check
- The remittance advice date to ensure the appeal is filed within the 60-day window.
- The adjustment reason code accompanying the N887 remark for details on the denial.
- The completed Waiver of Liability Statement for accuracy and signature.