M114Remark Code (RARC)Active
M114 Remark Code - DMEPOS Competitive Bidding Info
The M114 remark code indicates that the service was processed according to the DMEPOS Competitive Bidding Program or a related Demonstration Project. It signals to the biller that the adjustment made to the claim is based on specific rules and guidelines established for these programs.
How It Relates to the Denial
The M114 remark typically accompanies adjustment reason codes related to Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS). This combination suggests that the claim has been affected by the competitive bidding process or a demonstration project, impacting payment and coverage decisions.
Common Scenarios
1A claim for a wheelchair rental was submitted and returned with an adjustment indicating a reduced payment amount.
→ The M114 remark informs the biller that the payment adjustment is due to the competitive bidding rules that apply to the wheelchair service under DMEPOS.
2A claim for a power scooter was denied, and the remittance included a reason code about payment reduction along with the M114 remark.
→ In this case, the M114 remark clarifies that the denial or adjustment is in line with the guidelines of the DMEPOS Competitive Bidding Program.
3A provider submitted a claim for a hospital bed, and the remittance advised a payment adjustment with the M114 remark attached.
→ The M114 indicates that the adjustment reflects compliance with the DMEPOS rules, impacting the reimbursement for the hospital bed.
What to Do
- Review the claim adjustment reason code to understand the specific adjustment made.
- Contact your local contractor for detailed information regarding the DMEPOS Competitive Bidding Program or Demonstration Project rules that apply to the service.
- Ensure that any future claims for similar services comply with the DMEPOS guidelines.
What to Check
- The claim adjustment reason code accompanying the M114 remark for specific details on the adjustment.
- Documentation or contracts related to the DMEPOS Competitive Bidding Program.
- Eligibility and coverage policies for the specific DME service in question.