RARC N590: Independent Medical Exam Report Missing
The claim is missing a required independent medical examination report — obtain the IME report and resubmit with the documentation attached.
What Does RARC N590 Mean?
RARC N590 indicates that the payer requires an independent medical examination (IME) report to process the claim, and this report was not included with the submission. An IME is an evaluation performed by a physician who is not the treating provider, typically arranged by the payer or an employer to provide an objective assessment of the patient's condition, the cause of injury, and the medical necessity of ongoing treatment.
IME reports are most commonly required in workers' compensation, auto accident, and disability claims where the payer needs an independent clinical opinion before authorizing further treatment or payment. The report typically addresses causation (whether the condition is related to the covered event), the extent of the impairment, treatment appropriateness, and the patient's ability to return to work or normal activities.
Without the IME report, the payer cannot complete its adjudication process. The claim will remain unpaid until the documentation is provided, regardless of whether the underlying services are medically appropriate.
What to Do
Determine whether an IME has already been conducted. If so, contact the examining physician's office to obtain a copy of the completed report. Attach the report to the claim with a cover letter referencing the original claim number and RARC N590, then resubmit following the payer's documentation submission guidelines.
If no IME has been scheduled, contact the payer to coordinate the examination. The payer typically arranges and pays for the IME, but the provider's office may need to facilitate scheduling or provide records to the examining physician. Once the IME is completed and the report is available, submit it with the pending claim. Track the claim closely after resubmission, as payer review of IME documentation can add processing time.
Common Scenarios
- A workers' compensation claim for ongoing physical therapy is held pending an IME report that the employer's insurer requested but the results have not yet been forwarded to the claims processor
- An auto accident payer requires an IME to determine whether continued treatment is related to the accident, and the provider submits claims before the IME is completed
- The IME has been conducted but the examining physician's report has not been delivered to the payer, causing claims to be denied in the interim
- A disability insurer denies claims for treatment because the required IME documenting the nature and extent of the disability was not submitted with the initial claim
Commonly Paired With
RARC N590 commonly appears alongside these CARC denial codes: