M133Remark Code (RARC)Active
M133 Remark Code - Missing Diagnostic Test Info
The M133 remark code indicates that the claim lacks necessary details about the diagnostic test performed, specifically who conducted the test and the amount charged for it. This remark supplements an adjustment already noted by the accompanying reason code, providing clarity on what information is missing from the claim submission.
How It Relates to the Denial
The M133 remark code typically accompanies adjustment reason codes related to incomplete or insufficient claim information. Together, they signal that the payer requires specific details regarding the provider of the diagnostic test and the associated charges to process the claim accurately.
Common Scenarios
1A claim for a diagnostic imaging service was submitted, but the remittance shows the M133 remark code with a reason code indicating a denial due to incomplete information.
→ In this case, the M133 remark suggests that the claim did not specify the provider of the imaging service or the cost incurred for the procedure, which the payer needs to process the claim.
2A lab test claim was denied with M133 noted, and the reason code indicates that the claim was incomplete.
→ The M133 remark clarifies that the payer is looking for details on who performed the lab test and the amount billed, which were not included in the original claim.
3A facility billed for a diagnostic test but received a remittance with M133, indicating additional information was required for processing.
→ The appearance of M133 means the payer requires identification of the performing provider and the billed amount to proceed with the claim.
What to Do
- Gather the missing information about the provider who performed the diagnostic test.
- Include the amount charged for the diagnostic test in the claim resubmission.
- Correctly document the details in the claim to meet payer requirements.
What to Check
- Review the original claim submission for missing provider details.
- Check the billed amount for the diagnostic test to ensure it was included.
- Examine the accompanying reason code on the remittance for additional context on the denial.