N56 Denial Code
The procedure code does not match what was done, or was not valid on that date of service.
A remark code sits beside the adjustment code on the remit and says why the claim was reduced.
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A Remark Code Is Not the Denial
The adjustment code says the claim was reduced. This one says why. You need both to know what to send back.
What to Do
Check the code against the DATE, not against today. Code sets change every January, and a claim for December work submitted in February is judged on the December set.
Code meanings verified against x12.org/codes/remittance-advice-remark-codes. The wording, the pairing and the recommended action are ours, not the payer's.
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Your Questions Answered
What does denial code N56 mean?
The procedure code does not match what was done, or was not valid on that date of service.
What should I do about N56?
Check the code against the DATE, not against today. Code sets change every January, and a claim for December work submitted in February is judged on the December set.
Which denial codes appear with N56?
N56 commonly rides with CO 16, CO 4. The adjustment code says the claim was reduced; the remark code says why.
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