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N628 Remark Code: Same-Day Follow-Up Visit Disallowed

N628 means the payer disallowed an outpatient follow-up visit billed on the same date of service as a scheduled test or treatment. The payer considers the visit part of, or not separately payable with, the planned service that day.

Quick facts

Code
N628 (RARC N628)
Status
Active In use since July 15, 2013.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The visit is not separately payable. The provider writes it off; the patient should not be billed.
Official description
Out-patient follow up visits on the same date of service as a scheduled test or treatment is disallowed.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N628 means

When a patient comes in for a planned test or treatment, a brief check-in is usually part of that service. N628 says the payer saw a separate outpatient follow-up visit billed on the same day as that scheduled service and decided not to pay the visit.

It often appears with CARC 97, B14, or P14 on workers’ comp and auto claims.

Common causes

  • A follow-up visit was billed automatically whenever a treatment was performed.
  • The visit was routine monitoring related to the scheduled service.
  • Documentation didn’t show a separate reason for the visit.
  • The payer’s policy doesn’t allow both on the same day.

What to do

  1. Read the payer’s rule for same-day visits and scheduled services.
  2. Review the visit note for a distinct problem or significant change beyond the planned service.
  3. If it was separate, submit a corrected claim with modifier 25 and resubmission code 7, or appeal with documentation if the modifier was already there.
  4. If it wasn’t separate, write off the visit charge.

How to prevent it

Train providers and coders to bill same-day visits only when the note documents a separate evaluation. Payer-specific edits in your billing system can flag same-day visit and treatment combinations for review before release. For bundling logic in general, see NCCI and bundling denials.

Codes that may appear with N628

  • CO-97 (The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.): The benefit is included in the payment for another service.
  • CO-B14 (Only one visit or consultation per physician per day is covered.): Only one visit or consultation per physician per day is covered.
  • CO-P14 (The Benefit for this Service is included in the payment/allowance for another service/procedure that has been performed on the same day.): Included in another service performed the same day, for property and casualty claims.
  • N626 (New or established patient E/M codes are not payable with chiropractic care codes.): E/M not payable with chiropractic care codes.
  • M80 (Not covered when performed during the same session/date as a previously processed service for the patient.): Not covered when performed during the same session or date as a previously processed service.
  • N20 (Service not payable with other service rendered on the same date.): Service not payable with another service rendered on the same date.

N628 FAQ

What counts as a scheduled test or treatment?

A service planned in advance, such as a therapy session, injection, or diagnostic test. The key point is that the visit and the planned service fall on the same day.

Can the visit ever be paid?

If the patient had a new problem or a significant change requiring a separate evaluation, some payers will pay with appropriate documentation and modifier 25. Check the payer's policy.

Should I schedule the follow-up on a different day?

Only if it is clinically appropriate. Scheduling should follow patient care, but knowing the payer rule helps set expectations.