N822 remark code
A modifier the payer requires for this procedure code isn't on the line.
“Missing procedure modifier(s).”
Start 07/01/2019 · Last modified 11/01/2019 · X12 remark code list
What it usually means in behavioral health
N822 usually explains CO-4 or CO-16. In behavioral health the missing modifier is most often a telehealth modifier, a provider-level modifier a Medicaid program requires, or a payer-specific program modifier.
Common causes
- Telehealth service billed without the payer's telehealth modifier
- Medicaid claim without the required provider-level modifier for the clinician's degree
- Payer-specific ABA or program modifier not added
Correct and resubmit, or appeal?
Correct and resubmit with the required modifier. This is a claim-data fix, not an appeal.
What to do
Identify which modifier the payer requires for that code, setting, and clinician.
Add it and resubmit, following the payer's corrected-claim rules.
Build the rule into charge entry so it can't be skipped next time.
Often seen with
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