N939Remark Code (RARC)ActiveInformational Alert
N939 Remark Code - Peer-to-Peer Review Alert
The N939 code serves as an alert indicating that the payer is open to a peer-to-peer review. It suggests that providers can reach out for further discussion regarding the claim, potentially to clarify medical necessity or other factors related to the service provided.
What This Alert Tells You
As an informational alert, the N939 remark does not indicate any specific adjustment or denial. It is intended to inform providers that a peer-to-peer review is available for claims that may require further evaluation or discussion.
Common Scenarios
1A provider receives an 835 remittance showing the N939 alert after submitting a claim for a surgical procedure. The claim was initially processed without denial, but the payer is suggesting further communication.
→ In this case, the N939 alert indicates that the payer is willing to discuss the claim further, possibly to review the medical necessity of the procedure.
2A biller notices the N939 remark on an ERA following a claim submission for a diagnostic imaging service. The claim was paid but flagged for potential review.
→ Here, the N939 alert implies that the payer is open to a peer-to-peer review, suggesting that the provider may want to discuss the clinical details of the imaging service.
3After submitting a claim for a therapy session, the provider receives an 835 with the N939 remark. There was no denial, but the alert raises the possibility of a review.
→ The presence of the N939 alert indicates that the payer is inviting the provider to engage in a peer-to-peer review, which may help clarify any questions regarding the service.
What to Do
- Consider contacting the payer to initiate a peer-to-peer review if you have questions about the claim.
- Prepare relevant clinical documentation to discuss during the peer-to-peer review.
- Clarify any specific questions or concerns you may have about the claim before reaching out.
What to Check
- Review the claim details to identify any areas that may require clarification during the review process.
- Gather clinical documentation that supports the medical necessity of the services provided.
- Check the payer's contact information and procedures for initiating a peer-to-peer review.