M93Remark Code (RARC)Active
M93 Remark Code - Break in Therapy and Rental Period
The M93 remark code indicates that the information provided supports a break in therapy, which has resulted in the initiation of a new capped rental period for the equipment delivered. This remark supplements the adjustment described by the accompanying reason code, clarifying the rationale for the billing decision related to the rental equipment.
How It Relates to the Denial
The M93 remark code typically accompanies adjustment reason codes that relate to equipment rentals, specifically when there has been a change in therapy status. This combination signals that the payer recognizes a break in therapy necessitating a new rental period for the equipment involved.
Common Scenarios
1A patient previously receiving a rented wheelchair has had a break in therapy, and a claim for a new rental period is submitted after the equipment is delivered.
→ The M93 remark code indicates that the payer acknowledges the break in therapy and confirms that a new capped rental period has started with this delivery.
2A claim for a capped rental of oxygen equipment is submitted, but the patient had a gap in therapy due to hospitalization. The remittance includes the M93 remark code.
→ The M93 remark code signifies that the payer has recognized the therapy break and has determined that a new rental period for the oxygen equipment is warranted.
3A durable medical equipment provider submits a claim for a new rental of a CPAP machine after a patient was off therapy for several months, and the M93 remark code appears on the remittance.
→ The appearance of the M93 remark code indicates that the payer supports the break in therapy and confirms that a new capped rental period for the CPAP machine has begun with the latest delivery.
What to Do
- Review the accompanying claim adjustment reason code to understand the context of the adjustment.
- Ensure that the documentation supports the break in therapy to justify the new capped rental period.
- Confirm that the rental period complies with payer guidelines for capped rentals.
What to Check
- The patient's therapy records to verify the break in therapy.
- The delivery documentation for the equipment to confirm the start of the new rental period.
- The claim submission details to ensure all necessary information was provided.