M62Remark Code (RARC)Active
M62 Remark Code - Missing Treatment Authorization Code
The M62 remark code indicates that there is a missing, incomplete, or invalid treatment authorization code on the claim. This remark supplements a Claim Adjustment Reason Code by providing specific information regarding the authorization status, which is essential for the payer's processing of the claim.
How It Relates to the Denial
The M62 remark code typically accompanies adjustment reason codes related to authorization issues. This combination signifies that the claim cannot be processed due to a lack of proper authorization documentation.
Common Scenarios
1A provider submitted a claim for a surgical procedure but received a remittance stating that payment was denied due to missing authorization.
→ The M62 remark code indicates that the payer found an issue with the treatment authorization code, suggesting that the claim cannot be processed without proper authorization.
2A claim for physical therapy services was sent without an authorization number, resulting in an adjustment on the remittance advice.
→ The presence of the M62 remark code indicates that the payer requires a valid treatment authorization code for the claim to be considered for payment.
3A hospital claim for inpatient services was denied, and the remittance included an adjustment reason for lack of authorization along with the M62 remark.
→ The M62 remark code clarifies that the denial is due to an invalid or missing treatment authorization code, highlighting the need for proper documentation.
What to Do
- Obtain the correct treatment authorization code if it is missing.
- Ensure that any authorization submitted is complete and valid according to payer requirements.
- Resubmit the claim with the appropriate authorization code included.
What to Check
- Review the original claim submission for any missing authorization information.
- Check the payer's authorization guidelines to confirm what is needed for the specific service.
- Verify the treatment authorization code with the provider or authorization department.