M144Remark Code (RARC)Active
M144 Remark Code - Pre-/Post-Operative Care Payment
The M144 remark code indicates that the payment for pre-operative or post-operative care is included in the overall allowance for the surgery or procedure billed. This means that the payer is not providing additional payment for these services as they are considered part of the surgical fee.
How It Relates to the Denial
The M144 remark code typically accompanies claim adjustment reason codes that relate to the denial or reduction of payment for surgical services. Together, they signal that the payer has bundled the pre- and post-operative care into the surgical payment itself, rather than separating them out for individual reimbursement.
Common Scenarios
1A claim was submitted for a surgical procedure along with separate charges for pre-operative consultations and post-operative follow-up visits. The remittance received included the M144 remark code.
→ In this case, the M144 remark code signifies that the payer has bundled the pre- and post-operative care into the total amount paid for the surgery, indicating no separate payment will be made for those additional services.
2A provider bills for a knee surgery and includes charges for both pre-operative evaluations and post-operative care. The reimbursement report shows an adjustment with the M144 remark code.
→ Here, the M144 remark code is clarifying that the costs associated with the pre- and post-operative care are already factored into the payment for the knee surgery, resulting in no additional compensation for those services.
3After billing for a complex procedure, the provider receives an explanation of benefits that includes the M144 remark code along with a reduction in the total payment amount.
→ The M144 remark code in this scenario indicates that the reduction is due to the inclusion of pre- and post-operative care in the surgical procedure's allowance, which the payer considers comprehensive.
What to Do
- Review the surgical procedure code billed to confirm if it includes pre- and post-operative care in its allowances.
- Ensure that any separate charges for pre-operative and post-operative care were not mistakenly submitted as standalone claims.
- If applicable, adjust future billing practices to reflect that these services may be bundled with the surgical fee.
What to Check
- The claim adjustment reason code accompanying the M144 remark for additional context on the payment adjustment.
- The billing guidelines for the surgical procedure to confirm if pre- and post-operative care is included in the allowance.
- The surgery procedure's fee schedule to understand the bundled payment structure.