M142Remark Code (RARC)Active
M142 Remark Code: Missing Diabetes Certification
The M142 remark code indicates that the claim was denied due to the absence of an American Diabetes Association Certificate of Recognition. This remark supplements a claim adjustment reason code, providing additional context for the denial related to certification requirements.
How It Relates to the Denial
The M142 remark code typically accompanies claim adjustment reason codes that address certification or recognition issues. The combination signifies that the claim cannot be processed further until the necessary certification documentation is provided.
Common Scenarios
1A provider submitted a claim for diabetes education services, but the remittance came back with a denial indicating missing documentation.
→ In this case, the M142 remark code points to the need for the American Diabetes Association Certificate of Recognition to support the claim for reimbursement.
2A healthcare facility billed for a diabetes management program, and the payment was adjusted due to a lack of required certification.
→ The appearance of the M142 remark code suggests that the payer is looking for the specific American Diabetes Association Certificate of Recognition to validate the claim.
3A physician's office filed a claim for a diabetes-related consultation, and the remittance advised that the claim was denied due to missing credentials.
→ Here, the M142 remark code indicates that the claim requires the American Diabetes Association Certificate of Recognition to meet the payer's criteria for reimbursement.
What to Do
- Obtain the American Diabetes Association Certificate of Recognition for the service provided.
- Attach the certificate to a resubmission of the claim to support the reimbursement request.
- Ensure that the certificate is current and meets the payer's documentation standards.
What to Check
- Verify the claim documentation for the presence of the American Diabetes Association Certificate of Recognition.
- Check the payer's policy regarding certification requirements for diabetes education services.
- Review the claim adjustment reason code on the remittance for further details on the denial.