N892Remark Code (RARC)Active
N892 Remark Code - Delay Reason Code Criteria Issue
The N892 remark code indicates that the claim does not satisfy the required criteria for the use of the Delay Reason Code previously applied. This implies there may have been an inappropriate application of a delay code on the claim, which could affect the processing outcome.
How It Relates to the Denial
The N892 remark typically accompanies a Claim Adjustment Reason Code that relates to delays in processing. The combination of these codes suggests that while a delay was indicated, it was not justified according to the payer's guidelines.
Common Scenarios
1A provider submitted a claim for a scheduled procedure, and the remittance advice shows an adjustment with a delay reason code related to a late submission.
→ The N892 remark suggests that the delay reason code used was not appropriate for this claim, signaling the need for further review of the submission timeline.
2A claim for outpatient services was submitted, and the payer responded with an adjustment indicating a delay due to missing documentation.
→ The appearance of N892 indicates that the documentation delay reason code applied does not meet the payer's criteria, suggesting the need for additional supporting information.
3A hospital billed for inpatient services, and the remittance advice included an adjustment with a delay reason code due to pending authorization.
→ The N892 remark points out that the delay reason for pending authorization was not valid for this claim, which may require the provider to clarify authorization details.
What to Do
- Review the claim adjustment reason code to understand the context of the delay.
- Ensure that the appropriate delay reason code is being applied based on the payer's criteria.
- If applicable, gather and submit any additional documentation that supports the delay reason used.
What to Check
- The claim submission date to verify timeliness against the payer's guidelines.
- The documentation submitted with the claim to ensure it meets the criteria for the delay reason code.
- The payer's policy on acceptable delay reason codes to confirm compliance.