MA97Remark Code (RARC)Active
MA97 Remark Code - Medicare Contract Number Issues
The MA97 remark code indicates that the claim was denied due to a missing, incomplete, or invalid Medicare Managed Care Demonstration contract number or clinical trial registry number. This remark supplements an adjustment already explained by an accompanying reason code, providing additional clarity on the denial's cause.
How It Relates to the Denial
The MA97 remark code typically accompanies reason codes related to contract number or clinical trial registry issues. Its presence signals that the payer requires specific identification numbers to process the claim correctly.
Common Scenarios
1A provider submitted a claim for a service rendered under a Medicare Managed Care plan but received a denial indicating missing information. The remittance included the MA97 code alongside a reason code for a denied service.
→ In this case, the MA97 remark code points to the need for a valid Medicare Managed Care Demonstration contract number or clinical trial registry number, which was not provided or was incorrect.
2A clinical trial claim was submitted without the required registry number, and the remittance response included an adjustment for the denied claim with the MA97 code.
→ The MA97 remark suggests that the payer could not process the claim due to the absence or invalidity of the clinical trial registry number, indicating that this information must be corrected or supplied.
3A claim for a Medicare Managed Care service was returned with a denial that included MA97 after the submitted information was reviewed. The reason code indicated non-coverage due to lack of proper documentation.
→ Here, the MA97 remark highlights the specific reason for the denial, focusing on the missing or invalid contract number, which must be addressed to facilitate resubmission.
What to Do
- Verify the Medicare Managed Care Demonstration contract number is included and accurate on the claim.
- Check if a clinical trial registry number is required and ensure it is correct if applicable.
- Correct any inaccuracies in the submitted contract or registry numbers and resubmit the claim.
What to Check
- The original claim submission for completeness regarding the contract or registry number.
- The payer's requirements for the Medicare Managed Care Demonstration contract number.
- Any communication from the payer regarding specific contract or registry number expectations.