M122Remark Code (RARC)Active
M122 Remark Code - Missing Subluxation Level Explained
The M122 remark code indicates that there is a missing, incomplete, or invalid level of subluxation reported on the claim. This remark supplements a claim adjustment reason code by providing specific feedback about the subluxation details required for proper processing.
How It Relates to the Denial
The M122 remark code typically accompanies adjustment reason codes related to denied or reduced payments due to insufficient information regarding the level of subluxation. This combination signals that the payer seeks clarification or correction of the subluxation details before reconsidering payment.
Common Scenarios
1A chiropractor submits a claim for a spinal manipulation service but receives a denial indicating a lack of sufficient documentation for the subluxation level.
→ The M122 remark code suggests that the payer found the subluxation level missing or invalid, signaling that the chiropractor needs to provide more accurate details about the condition.
2An adjustment is made on a claim for a physical therapy service, and the remittance includes the M122 remark code along with a reason code for payment reduction.
→ In this case, the M122 remark code points to issues with the subluxation level documentation, indicating that the payer requires clarification to justify the billed amount.
3A claim for chiropractic services is processed, but the remittance advises a partial payment with the M122 remark code attached, referencing the level of subluxation.
→ The M122 remark code indicates that the payer has deemed the subluxation level information insufficient, which directly affects the amount reimbursed.
What to Do
- Review the claim documentation to ensure the level of subluxation is clearly stated and valid.
- If necessary, correct the claim details to accurately reflect the subluxation level and resubmit the claim for reconsideration.
What to Check
- The original claim submission to verify the documented level of subluxation.
- The payer's policy or guidelines regarding required documentation for subluxation levels.
- Any additional notes or comments from the payer regarding the denial or adjustment.