M23Remark Code (RARC)Active
M23 Remark Code - Missing Invoice Explained
The M23 remark code indicates that an invoice is missing from the documentation submitted for payment. This remark supplements an adjustment reason code that describes the denial or reduction of payment due to the absence of this required invoice.
How It Relates to the Denial
The M23 remark code typically accompanies adjustment reason codes that indicate a claim was denied or reduced due to insufficient documentation. The combination signals to the biller that the payer requires an invoice to process the claim correctly.
Common Scenarios
1A claim for a surgical procedure was submitted, but the remittance indicates a denial with the M23 remark code.
→ In this case, the M23 remark points out that an invoice for the surgical procedure is missing, which is necessary for the payer to validate the service and process payment.
2A claim for durable medical equipment was billed, but the payer returned it with a denial stating missing documentation, accompanied by the M23 remark code.
→ The M23 remark suggests that the payer did not receive the required invoice for the equipment, which must be submitted to resolve the denial.
3A claim for laboratory services was submitted, and the remittance shows a reduction in payment with the M23 remark code listed.
→ This indicates that the payer has reduced the payment because the invoice required to support the claim is missing.
What to Do
- Obtain the missing invoice related to the claim in question.
- Submit the invoice to the payer as part of the reconsideration process.
- Ensure that all future claims include the necessary invoices to avoid similar issues.
What to Check
- Check the claim submission records for the invoice.
- Review the remittance advice for the accompanying adjustment reason code.
- Verify the payer's documentation requirements for claims to ensure compliance.