MA133Remark Code (RARC)Active
MA133 Remark Code - Overlapping Inpatient Stay Guidance
The MA133 remark code indicates that the claim overlaps with an inpatient stay. The biller should only rebill for services that were provided outside of the inpatient admission period.
How It Relates to the Denial
The MA133 remark typically accompanies other claim adjustment reason codes that relate to overlapping services. This combination signals that a portion of the billed services cannot be reimbursed due to the inpatient stay.
Common Scenarios
1A facility submits a claim for outpatient physical therapy services provided to a patient who was also hospitalized during the same timeframe. The remittance shows the MA133 remark code.
→ In this scenario, the MA133 remark indicates that the therapy services overlap with the inpatient stay, and only those services rendered outside the stay can be rebilled.
2A claim for laboratory tests is submitted for a patient who was admitted to the hospital during the testing period. The remittance includes the MA133 remark code.
→ Here, the MA133 remark alerts the biller that the laboratory tests overlap with the inpatient stay, and they should focus on rebilling only the tests performed after discharge.
3A hospital submits a claim for a series of radiology services provided while a patient was admitted. The remittance response includes the MA133 remark code.
→ The MA133 remark indicates that these radiology services cannot be fully billed due to their overlap with the inpatient stay, directing the biller to rebill only the services rendered after the patient was discharged.
What to Do
- Review the services listed on the claim and identify which ones were provided during the inpatient stay.
- Rebill only the services that were delivered outside the inpatient admission period, ensuring accurate dates of service are used.
What to Check
- The inpatient admission and discharge dates for the patient.
- The service dates on the claim to confirm which fall outside the inpatient stay.
- The original claim submission to ensure compliance with the MA133 remark.