For healthcare providers and practice managers, N214 denials (“Missing/invalid history of initial surgery”) create unnecessary payment delays and revenue loss. These denials occur when payers can’t verify a patient’s previous surgical procedures.
Why N214 Denials Happen
Top Causes:
✔ Incomplete documentation of prior surgeries
✔ Outdated EHR surgical history records
✔ Incorrect procedure/diagnosis coding
✔ Missing dates or details of initial procedures
✔ Lack of communication between providers
5 Strategies to Prevent N214 Denials
1. Strengthen Surgical Documentation
- Maintain complete records, including:
- Original surgery date
- Procedure details
- Surgeon information
- Follow-up care notes
2. Implement Cross-Provider Verification
- Establish protocols to obtain surgical histories from:
- Referring physicians
- Previous care facilities
- Patient medical records
3. Enhance EHR Management
- Audit surgical history sections quarterly
- Set alerts for missing/incomplete data
- Standardize documentation templates
4. Improve Coding Accuracy
- Verify that procedure codes match the surgical history
- Use modifiers correctly for related procedures
- Conduct monthly coding audits
5. Train Staff on Best Practices
- Educate on complete surgical documentation
- Create checklists for claim submission
- Review denial trends monthly
Financial Impact of N214 Denials
Each N214 denial:
- Delays payments by 30-45 days
- Costs $50-$100Â in staff time to resolve
- Represents 5-15%Â of preventable surgical claim rejections
Need Help Reducing N214 Denials?
Claims Med specializes in:
✔ Surgical claim denial prevention
✔ Medical documentation improvement
✔ Revenue cycle optimization