N90Remark Code (RARC)Active
N90 Remark Code - Covered Only When Performed by Attending Physician
The N90 remark code indicates that the service billed is only covered when provided by the attending physician. This suggests the claim was adjusted based on who performed the service, and the payer does not reimburse for it if it was conducted by someone other than the attending physician.
How It Relates to the Denial
The N90 remark typically accompanies a Claim Adjustment Reason Code that indicates a denial or adjustment due to provider qualifications or service performance issues. This combination signals that the service in question did not meet the payer's criteria for coverage based on the performing provider.
Common Scenarios
1A claim for a procedure performed by a physician's assistant is submitted, but the remittance shows the N90 remark code.
→ In this case, the N90 remark points out that the procedure is only covered when performed by the attending physician, indicating that reimbursement is denied because it was not performed by the required provider.
2A surgical service billed by a nurse practitioner returns with an adjustment and the N90 remark on the remittance advice.
→ Here, the N90 remark indicates that the service is not covered since it was not performed by the attending physician, which aligns with the payer’s policy.
3An office visit claim submitted by a physician is denied with the N90 remark, although the attending physician was present.
→ In this scenario, the N90 remark suggests that there may be a misunderstanding or error regarding who provided the service, as it emphasizes the requirement for the attending physician to perform the service for coverage.
What to Do
- Review the provider's qualifications for the billed service to ensure compliance with payer policies.
- Verify that the attending physician performed the service as required by the payer's coverage criteria.
- If applicable, consider resubmitting with clarification or additional documentation that confirms the attending physician's involvement.
What to Check
- The claim documentation to confirm the provider who performed the service.
- The payer's policy regarding coverage limitations based on provider type.
- The eligibility response to see if the attending physician was correctly identified in the claim.