N940Remark Code (RARC)Active
N940 Remark Code - Missing/Incomplete X-Ray Explanation
The N940 remark code indicates that the claim has a missing, incomplete, or invalid pre-operative or post-operative x-ray. This remark is meant to clarify the reason for an adjustment already provided by the accompanying reason code on the remittance advice.
How It Relates to the Denial
The N940 remark typically accompanies claim adjustment reason codes that pertain to insufficient documentation or lack of required imaging studies. Together, they signal that additional information regarding x-ray documentation is needed to support the claim.
Common Scenarios
1A surgical procedure was billed, but the remittance shows an adjustment due to missing documentation.
→ The N940 remark points to the absence of required pre- or post-operative x-rays that the payer expects to see as part of the surgical documentation.
2A claim for a hip replacement includes an adjustment for insufficient documentation, and the remittance states that the pre-operative x-ray is missing.
→ The presence of the N940 remark indicates that the claim cannot be processed further due to the missing pre-operative x-ray that is needed to support medical necessity.
3A provider submitted a claim for a surgical procedure, but the remittance returned an adjustment indicating incomplete documentation, with the N940 remark attached.
→ The N940 remark suggests that the payer found the submitted x-ray documentation inadequate or not meeting their requirements, leading to the adjustment.
What to Do
- Obtain and submit the required pre-operative or post-operative x-ray documentation as specified by the payer.
- Ensure that any x-ray images submitted are complete and clearly labeled to avoid further issues.
What to Check
- Review the claim documentation for the presence of required x-ray images.
- Check the claim adjustment reason code for specifics on what documentation is missing or deemed invalid.
- Pull the surgical notes to ensure that they reference the required imaging studies.