M136Remark Code (RARC)Active
M136 Remark Code - Physician Supervision Required
The M136 remark code indicates that there is a missing, incomplete, or invalid indication that a physician supervised or evaluated the service provided. This remark serves to clarify an adjustment that has already been made under a Claim Adjustment Reason Code regarding supervision or evaluation by a physician.
How It Relates to the Denial
The M136 code typically accompanies adjustment reason codes related to the supervision or evaluation of services, indicating that proper documentation or notation of physician involvement is needed. This combination signals to the biller that there is a compliance issue regarding physician oversight.
Common Scenarios
1A claim for physical therapy services was submitted, indicating that a physician supervised the treatment. The remittance shows an adjustment along with the M136 remark.
→ In this case, the M136 remark suggests that the payer found the documentation lacking in confirming the physician's supervision, which needs to be addressed for proper reimbursement.
2A behavioral health service was billed with a note that a psychiatrist evaluated the patient. The remittance returned an adjustment with the M136 remark attached.
→ Here, the M136 remark points out that the claim lacks sufficient evidence that the psychiatrist's evaluation was properly documented, affecting the payment decision.
3A surgical procedure claim was submitted, claiming that a physician evaluated the patient's condition prior to surgery. The remittance includes an adjustment and the M136 remark.
→ The M136 indicates that the payer requires clearer documentation showing that the physician's evaluation occurred as stated, which is necessary for the claim's validity.
What to Do
- Review the documentation for the service to ensure there is a clear indication of physician supervision or evaluation.
- If the documentation is incomplete, obtain the necessary physician notes or signatures to support the claim.
- Resubmit the claim with the corrected information to facilitate proper processing.
What to Check
- The original claim documentation, including notes on physician involvement.
- Any relevant physician supervision or evaluation forms that may have been submitted.
- The accompanying reason code on the remittance for additional context on the adjustment.