M20Remark Code (RARC)Active
M20 Remark Code - Missing/Invalid HCPCS Explained
The M20 remark code indicates that there is a missing, incomplete, or invalid HCPCS code on the claim. This remark supplements an adjustment made by a Claim Adjustment Reason Code, providing additional context for the denial or reduction of the payment.
How It Relates to the Denial
The M20 remark typically accompanies adjustment reason codes that indicate payment issues due to coding errors or omissions. The combination signals that the billing office needs to address the HCPCS code specifically to resolve the adjustment.
Common Scenarios
1A provider submitted a claim for a physical therapy session but received an adjustment indicating a payment reduction due to coding issues.
→ The M20 remark suggests that the HCPCS code for the physical therapy service was either missing or incorrect, prompting the payer to adjust the payment.
2A facility billed for a surgical procedure but got back a remittance with an adjustment stating the procedure was not covered.
→ The presence of the M20 remark indicates that the HCPCS code provided for the surgical procedure was invalid or incomplete, leading to the coverage denial.
3A provider’s claim for a diagnostic test was denied, and the remittance included an adjustment with the M20 remark.
→ This indicates that the HCPCS code associated with the diagnostic test was not correctly reported, which is necessary for proper reimbursement.
What to Do
- Review the HCPCS code submitted on the claim for accuracy and completeness.
- Correct any errors in the HCPCS code and resubmit the claim if necessary.
What to Check
- The original claim submission to verify the HCPCS code used.
- Payer guidelines for valid HCPCS codes related to the services billed.
- Any accompanying documentation that supports the HCPCS code to ensure compliance.