MA42Remark Code (RARC)Active
MA42 Remark Code - Missing Admission Source Explained
The MA42 remark code indicates that there is a missing, incomplete, or invalid admission source related to the claim. This remark supplements the information provided by the accompanying reason code, clarifying that the admission source needs to be corrected or provided for proper processing.
How It Relates to the Denial
Typically, MA42 accompanies adjustment reason codes that indicate a claim is being denied or adjusted due to insufficient information regarding the patient's admission source. The combination of these codes signals that the claim cannot be processed until this specific information is resolved.
Common Scenarios
1A hospital billed for an inpatient service but received a denial indicating missing information. The remittance includes MA42 along with a reason code for incomplete information.
→ In this case, MA42 points out that the admission source was not provided or is invalid, which the payer needs to process the claim correctly.
2A provider submitted a claim for a procedure performed on a patient who was admitted under unclear circumstances. The remittance returned with an adjustment and MA42.
→ Here, MA42 suggests that clarification on the admission source is necessary, as the payer cannot process the claim without this detail.
3A skilled nursing facility submitted a claim for a patient but received an adjustment indicating that the admission source was not identified. MA42 was included in the remittance advice.
→ MA42 indicates that the facility must rectify the admission source information to fulfill the payer's requirements for processing the claim.
What to Do
- Review the admission source information on the claim and ensure it is complete and accurate.
- Contact the facility or provider to obtain the correct admission source if it is missing or unclear.
- Resubmit the claim with the corrected admission source details included.
What to Check
- The original claim form for the admission source field.
- The patient's medical record to verify the admission source used during the admission process.
- Any prior correspondence with the payer regarding the claim for additional context on the denial.