Which denial codes appear with N115?

N115 commonly rides with CO 50, PR 96. The adjustment code says the claim was reduced; the remark code says why.

Remark code

N115 denial code

The decision came from a Local Coverage Determination, the regional Medicare policy that says when this service is covered.

Usually an appeal

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

Find the LCD by number and read its covered indications and its diagnosis list. Then check the diagnosis actually on the claim. Most of these are won by adding the supporting diagnosis that was in the chart and never made it onto the claim.

Codes it appears with

N115 commonly rides alongside these. Our reading, not a published mapping: X12 publishes no adjustment-to-remark table.

Code	What that one means
CO 50	The payer decided the service was not medically necessary.
PR 96	Not a covered charge under this plan.

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