M143Remark Code (RARC)Active
M143 Remark Code - Update License Information Needed
The M143 remark code indicates that the provider needs to update their license information with the payer. This code supplements an adjustment reason code by specifying that the claim cannot be processed due to outdated or missing licensing details for the provider.
How It Relates to the Denial
The M143 remark code typically accompanies adjustment reason codes that indicate a claim cannot be processed because of provider credentialing issues. Together, they signal that the claim is on hold until the provider's licensing information is current and verified.
Common Scenarios
1A physician submitted a claim for a consultation service, but the remittance indicates a denial for lack of proper licensing.
→ The appearance of the M143 remark code suggests that the payer has found the provider's license information to be outdated or missing, necessitating an update before the claim can be processed.
2A facility billed for outpatient surgery, but the payment was reduced, and the remittance included the M143 remark code.
→ This indicates that the facility's license information is not up to date, and the payer requires that it be rectified for the payment adjustment to be reconsidered.
3A provider submitted a claim for physical therapy services, and the remittance shows an adjustment with the M143 remark code attached.
→ The M143 code means the payer has flagged the claim due to licensing issues, and the provider must take action to update their license details with the payer.
What to Do
- Contact the payer to determine what specific license information needs updating.
- Gather the current license documentation to ensure it meets the payer's requirements.
- Submit the updated licensing information to the payer as instructed.
What to Check
- The provider's current license status and expiration date.
- Any correspondence from the payer regarding licensing updates.
- The claim submission details to confirm all required information was included.