M27Remark Code (RARC)ActiveInformational Alert
M27 Remark Code - Liability Relief Alert
The M27 alert indicates that the patient is not liable for payment for certain items and services due to the limitation of liability provision. The provider remains responsible for these waived charges because they were deemed not reasonable and necessary, or classified as custodial care, and the provider should have known this.
What This Alert Tells You
The M27 alert is informational and does not accompany any specific adjustment or denial reason code. It serves to inform providers of their liability status when services rendered may not meet coverage criteria.
Common Scenarios
1A provider receives an 835 indicating that services provided to a patient were not covered, and the M27 alert appears on the remittance advice.
→ In this case, the M27 alert signifies that the patient is not responsible for payment, and the provider must address the liability for the services rendered.
2A biller notices the M27 alert on a remittance for custodial care services that were billed to a patient but denied by the payer.
→ This alert informs the biller that the patient is not liable for these charges, and the provider must accept responsibility for the costs associated with the custodial care.
3A claim submission results in an 835 with the M27 alert after a patient was treated for non-covered services, and the provider expected payment from the patient.
→ The M27 alert indicates that the provider cannot collect from the patient as they are relieved of financial responsibility for those non-covered services.
What to Do
- Do not resubmit the claim as it is not a denial requiring correction.
- Consider appealing the determination if you believe the services were reasonable and necessary.
What to Check
- Review the patient's eligibility and coverage determination documents.
- Check the details of the services rendered against the payer's coverage guidelines.
- Examine the provider's documentation to determine if due care was exercised in the treatment provided.