RARC N572: Non-Payable Reporting Codes or Modifiers Required
The claim is missing required non-payable reporting codes or quality measure modifiers — add the applicable reporting codes and resubmit.
What Does RARC N572 Mean?
RARC N572 indicates that the claim lacks non-payable reporting codes and their associated modifiers that the payer requires for processing. These reporting codes do not generate separate payment but are mandatory for quality reporting programs, value-based payment adjustments, or regulatory compliance tracking.
This remark is most commonly associated with Medicare quality programs such as the Merit-based Incentive Payment System (MIPS), formerly the Physician Quality Reporting System (PQRS). Under these programs, providers must submit specific G-codes, quality data codes (QDCs), or measure-specific modifiers alongside the billable procedure codes. Without these reporting elements, the payer may hold or deny the claim rather than process it without the required quality data.
N572 can also appear when functional limitation reporting codes are missing for therapy services, or when certain payers require tracking codes for specific clinical programs or demonstrations. The key distinction is that the missing codes are informational — they carry a zero charge — but their absence prevents the claim from being processed.
What to Do
Identify which reporting program applies to the billed service and provider. Review the payer's quality reporting requirements to determine the specific non-payable codes and modifiers needed. For MIPS measures, consult the current CMS MIPS measure specifications to find the applicable G-codes and quality modifiers for the services rendered.
Add the required reporting codes as additional line items on the claim with a zero charge amount, attach the appropriate modifiers, and resubmit. Going forward, consider building these reporting codes into your charge capture templates or EHR workflows so they are automatically included when qualifying services are documented. If you are unsure which codes are needed, the payer's provider relations department or CMS quality reporting resources can clarify the requirements.
Common Scenarios
- A physician bills for a qualifying MIPS measure but does not include the associated G-code and performance modifier on the claim
- Therapy claims are submitted without the required functional limitation reporting G-codes that track the patient's functional status
- A practice participating in a CMS demonstration project omits the required tracking code from claims for services rendered under the program
- Quality measure modifiers indicating whether a measure was met or not met are left off a claim that requires them for value-based payment calculation
Commonly Paired With
No common pairings documented yet.