MA123Remark Code (RARC)Active
MA123 Remark Code - Non-Participation in Study
The MA123 remark code indicates that the center was not selected to participate in a specific study, which is the reason for the denial of payment for the services billed. This remark supplements an adjustment already noted by the accompanying reason code, clarifying why payment cannot be made.
How It Relates to the Denial
The MA123 remark typically accompanies adjustment reason codes related to non-coverage or denial based on study participation criteria. This combination signals to the biller that the services rendered are not eligible for reimbursement due to the provider's non-participation in the relevant study.
Common Scenarios
1A facility billed for a series of diagnostic tests performed for a clinical trial. The remittance included a denial for those services.
→ The MA123 remark indicates that the facility is not part of the study network, resulting in the denial of payment for the billed tests.
2A provider submitted a claim for services rendered during a research project, but the remittance returned a denial with the MA123 remark code.
→ The MA123 remark clarifies that the provider's center was not selected for the study, which is why the services cannot be reimbursed.
3A healthcare provider billed for a treatment that was part of a study but received a denial indicating non-eligibility for payment.
→ Here, the MA123 remark signifies that since the center did not participate in the study, the payer cannot authorize payment for the related services.
What to Do
- Review the accompanying reason code for details on the adjustment.
- Do not resubmit the claim unless the center becomes eligible for the study or if the services are covered under a different provision.
What to Check
- The claim adjustment reason code that accompanies the MA123 remark.
- The participation criteria for the study mentioned in the claim.
- Any communication from the payer regarding participation in studies or trials.