M15Remark Code (RARC)Active
M15 Remark Code - Bundled Services Explained
The M15 remark code indicates that separately billed services or tests have been bundled together because they are considered components of the same procedure. As a result, separate payment for these services is not permitted.
How It Relates to the Denial
The M15 remark code typically accompanies a Claim Adjustment Reason Code that indicates a bundling adjustment. This combination signals that the services billed were deemed part of a single procedure, and only the comprehensive payment will be issued.
Common Scenarios
1A hospital bills separately for a lab test and an imaging service performed during the same visit. The remittance shows a denial for the lab test with the M15 remark code.
→ In this case, the M15 remark code clarifies that the lab test was bundled with the imaging service, and separate payment will not be made for the test.
2A provider submits claims for multiple surgical procedures done on the same day. The payer adjusts one of the claims with a bundling adjustment and includes the M15 remark code.
→ Here, the M15 remark code indicates that the payer has determined the procedures are components of a single surgical event, hence only one payment will be processed.
3A clinic bills for a consultation and a follow-up procedure on the same date of service. The remittance response shows an adjustment with the M15 remark code attached to the follow-up procedure.
→ The M15 remark code suggests that the follow-up procedure is bundled with the consultation, meaning it will not receive separate payment.
What to Do
- Review the services that were billed to ensure they are distinct procedures.
- Check the bundled service policy for the payer to understand which services are typically combined.
- Consider whether any documentation can support separate payments if applicable.
What to Check
- The claim adjustment reason code accompanying the M15 remark for context on the adjustment made.
- The documentation for the services billed to confirm they are distinct and not components of another procedure.
- The payer's bundling policy to understand how they define bundled services.