Denial code N255

Remark code M76 indicates a claim rejection due to missing, incomplete, or invalid diagnosis or condition information.

Remark code M77 indicates a claim issue due to missing or incorrect place of service details, requiring correction for processing.

Remark code M79 indicates a claim issue due to missing, incomplete, or invalid charge information, requiring correction.

Remark code M8 indicates denial of blood gas test claims if performed by a supplier or while the patient is on oxygen.

Remark code M80 indicates a service isn't covered if performed in the same session/date as a service already processed for the patient.

Remark code M81 indicates that claims must be coded with the most detailed diagnosis information available.

Remark code M82 indicates a service isn't covered by insurance if the patient is under 50 years old.

Remark code M83 indicates a service is not covered unless the patient meets high-risk criteria.

Remark code M84 indicates that billing must use medical codes valid on the service date for claims acceptance.

Remark code M85 indicates a review of physician evaluation and management services for billing accuracy.

Remark code M86 indicates a service was denied as it was already paid for a similar procedure within a specific time period.

Remark code M87 indicates a claim/service is under CFO-CAP prepayment review for compliance before payment.

Remark code M89 indicates a service isn't covered if repeated before age 40, signaling a limit on frequency for patients under this age.

Remark code M9 indicates the tenth rental month for equipment, prompting providers to offer patients a purchase option.

Remark code M90 indicates a service isn't covered if performed more than once within a 12-month period.

Remark code M91 indicates that lab tests under different CLIA certifications require separate billing claims for proper processing.

Remark code M93 indicates a therapy break, starting a new rental period for the delivered equipment, as supported by provided information.

Remark code M94 indicates that provided information fails to justify a therapy break, thus a new capped rental period won't start.

Remark code M95 indicates services are under review or audit due to the Home Health Initiative.

Remark code M96 indicates that only inpatient facilities can bill for technical service components; providers should bill for professional components only.

Remark code M97 indicates a service not paid to a practitioner as it's included in the facility's payment for the patient's place of service.

Remark code M99 indicates a claim issue due to a missing, incomplete, or invalid Universal Product Number/Serial Number.

Remark code MA01 indicates a right to appeal if you disagree with the payment decision; submit your appeal within 120 days of notice receipt.

Remark code MA02 indicates a right to appeal a determination. Providers must submit a written appeal within 180 days of notice receipt.

Remark code MA04 indicates a secondary claim requires primary payer details, which were missing or unreadable, to process payment.

Remark code MA07 indicates that the claim details have been sent to Medicaid for additional review.

Remark code MA08 indicates supplemental coverage is not Medigap or you're not in Medicare; claim info wasn't forwarded.

Remark code MA09 indicates a claim was filed as unassigned but treated as assigned per the existing agreement.

Remark code MA10 indicates a patient overpayment that requires the healthcare provider to issue a refund to the patient.

Remark code MA100 indicates a claim issue due to missing or invalid date of current illness or symptoms.

Remark code MA103 indicates an additional payment adjustment for hemophilia treatment services.

Remark code MA106 indicates a PIP claim, alerting providers of payment adjustments under the Periodic Interim Payment system.

Remark code MA107 indicates a paper claim was rejected due to over three data items in field 19, requiring correction.

Remark code MA108 indicates a paper claim was rejected due to multiple data items in field 23, requiring correction for processing.

Remark code MA109 indicates a claim was settled following ambulatory surgical payment rules.

Remark code MA110 indicates a claim was denied due to missing or invalid details on whether diagnostic tests were done externally or included.

Remark code MA111 indicates a claim issue due to missing or invalid test purchase price, or lab details.

Remark code MA112 indicates a claim issue due to missing or invalid group practice information, requiring correction for processing.

Remark code MA113 indicates a claim rejection due to an invalid or incomplete TIN. Correct your TIN to resubmit and process claims; patient billing is on hold.

Remark code MA114 indicates a claim was denied due to missing or incorrect details about the service location.

Remark code MA115 indicates an error due to missing or invalid location details for services in a Health Professional Shortage Area.

Remark code MA116 indicates a claim issue where the 'Homebound' status is missing, affecting lab service location validation.

Remark code MA117 indicates a $1.00 user fee has been applied to the claim by the payer for processing.

Remark code MA118 indicates that Medicare has not issued payment for services provided to a veteran at a VA facility, with applicable coinsurance or deductible.

Remark code MA12 indicates a billing issue where legal entitlement to charge for services by the provider in question has not been proven.

Remark code MA120 indicates a claim was denied due to a missing, incomplete, or invalid CLIA certification number.

Remark code MA121 indicates an issue with a claim due to a missing, incomplete, or invalid x-ray date, requiring correction.

Remark code MA122 indicates a claim issue due to a missing or incorrect initial treatment date.

Remark code MA123 indicates your center wasn't chosen for a study, thus payment for services is not approved.

Remark code MA125 indicates that, by law, the payment received is considered full settlement with no additional billing allowed.

Remark code MA126 indicates coverage for a pancreas transplant is only provided if a kidney transplant is also performed.

Remark code MA128 indicates a claim denial due to a missing or invalid FDA approval number on medical documentation.

Remark code MA13 alerts healthcare providers that billing patients for unreported amounts with PR group code may incur penalties.

Remark code MA130 indicates a claim was rejected due to incomplete/invalid info and must be resubmitted with correct details for processing.

Remark code MA131 indicates a physician has been paid for services tied to a demo claim; the claim must be withdrawn and payment refunded for processing.

Remark code MA132 indicates an adjustment made to align charges with the pre-demonstration rate for specific services.

Remark code MA133 indicates a claim conflict with an inpatient stay; services billed should exclude those provided during that stay.

Remark code MA134 indicates a claim issue due to a missing or invalid provider number for the patient's residence facility.

Remark code MA14 indicates a one-time payment for services outside a patient's prepaid health plan, with future non-plan services not covered.

Remark code MA15 indicates your claim was split to speed up processing; expect a notice for the remaining services soon.

Remark code MA16 indicates the patient has Black Lung coverage; claims should be directed to the Dept. of Labor, Federal Black Lung Program.

Remark code MA17 indicates that the primary insurer has paid and providers must seek refunds from any secondary insurer that overpaid.

Remark code MA18 indicates that claim details have been sent to the patient's supplemental insurer for further processing.

Remark code MA19 indicates that a claim wasn't sent to Medigap due to incorrect insurer information; providers should verify and resubmit directly.

Remark code MA20 indicates a denial for SNF coverage when care mainly involves urethral catheter use for convenience or incontinence control.

Remark code MA21 alerts providers of a name and sex mismatch in SSA records, requiring verification for accurate billing.

Remark code MA22 indicates a payment under $1.00 was not issued, as it's below the minimum threshold for processing.

Remark code MA23 indicates a demand bill has been approved following a medical review process.

Remark code MA24 indicates a billing overlap for Christian Science Sanitarium/SNF services within the same benefit period.

Remark code MA25 indicates if a patient has switched hospice providers, they cannot change again within the same benefit period.

Remark code MA26 alerts healthcare providers that a billing rule was previously communicated to them.

Remark code MA27 indicates a claim issue due to a missing, incomplete, or invalid entitlement number or name.

Remark code MA28 indicates a notice for non-assignment accepting physicians/suppliers, serving informational purposes only without granting extra appeal rights.

Remark code MA30 indicates a claim was denied due to a missing, incomplete, or invalid type of bill on the submission.

Remark code MA31 indicates an issue with the billing period dates, which are either missing, incomplete, or invalid on a claim.

Remark code MA32 indicates a claim issue due to missing or invalid covered days within the billing period.

Remark code MA33 indicates a claim issue due to missing, incomplete, or invalid non-covered days in the billing period.

Remark code MA34 indicates an error due to missing or incorrect coinsurance days in the billing period for a claim.

Remark code MA35 indicates an issue with the number of lifetime reserve days reported; they are missing, incomplete, or invalid.

Remark code MA36 indicates a claim issue due to a missing, incomplete, or invalid patient name, requiring correction for processing.

Remark code MA37 indicates a claim issue due to a missing, incomplete, or invalid patient address, requiring correction for processing.

Remark code MA39 indicates a claim denial due to missing, incomplete, or invalid gender information on the submitted form.

Remark code MA40 indicates a claim denial due to a missing, incomplete, or invalid admission date on the submitted documentation.

Remark code MA41 indicates a claim issue due to missing, incomplete, or invalid admission type information.

Remark code MA42 indicates a claim issue due to missing, incomplete, or invalid admission source information.

Remark code MA43 indicates a claim issue due to missing, incomplete, or invalid patient status information.

Remark code MA44 indicates a final decision with no appeal rights, as the adjudication is based on legal grounds.

Remark code MA45 indicates that, as notified before, part or all of your payment is reserved in a special account.

Remark code MA46 indicates that despite reviewing new information, no extra payment will be made.

Remark code MA47 indicates a provider opted out of Medicare, agreeing not to bill for services. Thus, Medicare won't pay this claim; the patient must cover costs.

Remark code MA48 indicates an issue with the name or address details of the responsible party or primary payer in billing documents.

Remark code MA50 indicates a claim issue due to a missing or invalid Investigational Device Exemption or Clinical Trial number.

Remark code MA53 indicates an issue with the Competitive Bidding Demonstration Project ID; it's missing, incomplete, or invalid.

Remark code MA54 indicates a delay in receiving the required physician certification or election consent for hospice care.

Remark code MA55 indicates a service isn't covered because the patient chose medical care, nullifying their election for religious non-medical health services.

Remark code MA56 indicates a provider opted out of Medicare and can't bill Medicare. The patient must pay, but charges are limited by law.

Remark code MA57 indicates a patient has revoked their request for non-medical health care due to religious reasons.

Remark code MA58 indicates a claim issue due to missing or invalid release of information indicator.

Remark code MA59 indicates a patient overpayment. Providers must refund the excess within 30 days as per the patient responsibility amount.

Remark code MA60 indicates an issue with the patient's relationship to the insured; it's missing, incomplete, or invalid.