N936Remark Code (RARC)Active
N936 Remark Code - Medicare MPPR Explanation
The N936 remark code indicates that the billed service has been classified as a secondary or tertiary procedure, which is affected by the Medicare Multiple Procedure Payment Reduction (MPPR) rule. This code supplements an adjustment already described by a Claim Adjustment Reason Code, providing additional context about how the MPPR applies to the services billed.
How It Relates to the Denial
The N936 remark typically accompanies adjustment reason codes that relate to payment reductions based on multiple procedures being billed on the same date. The combination signals that while a primary procedure may be reimbursed at full value, associated secondary or tertiary procedures are subject to a reduction under the MPPR rule.
Common Scenarios
1A provider submits a claim for a surgical procedure along with two related follow-up services. The remittance returns a reduction in payment for the follow-up services.
→ The N936 remark shows that the follow-up services are classified as secondary or tertiary procedures, which means they are subject to the MPPR, leading to a reduced payment.
2An outpatient clinic bills for multiple therapy sessions performed on the same day, and the remittance indicates a lower payment for the subsequent sessions.
→ The N936 remark indicates that these subsequent therapy sessions are considered secondary procedures under the MPPR, which accounts for the payment reduction.
3A hospital bills for a series of diagnostic tests conducted during a single patient visit, and the remittance shows a reduced payment for some of the tests.
→ The N936 remark clarifies that those tests are secondary or tertiary procedures affected by the MPPR, explaining the lower reimbursement.
What to Do
- Review the claim to confirm the procedure codes billed and their order as primary, secondary, or tertiary.
- Verify the application of the MPPR rule to the services in question, ensuring compliance with Medicare guidelines.
- If necessary, adjust future claims to reflect the proper coding order to minimize payment reductions.
What to Check
- The claim submission details to confirm the order of procedure codes.
- The Medicare Multiple Procedure Payment Reduction policy for guidance on affected services.
- The remittance advice for any accompanying adjustment reason codes that provide context for the N936 remark.