MA99Remark Code (RARC)Active
MA99 Remark Code - Medigap Information Issues
The remark code MA99 indicates that there is missing, incomplete, or invalid Medigap information related to the claim. This remark supplements an adjustment already detailed by a Claim Adjustment Reason Code, providing additional context for the denial or adjustment decision.
How It Relates to the Denial
The MA99 remark typically accompanies adjustments related to claims where Medigap coverage is a factor. It signals that the information regarding the Medigap policy needs to be corrected or completed to proceed with the claim processing.
Common Scenarios
1A claim for a patient with dual Medicare and Medigap coverage is submitted, but the remittance shows a denial with MA99.
→ In this case, MA99 indicates that the necessary Medigap information was not provided or was incorrect, and the payer expects this data to be submitted for proper processing.
2A provider submits a claim for a procedure covered by Medicare, but the remittance response includes MA99 due to missing Medigap policy details.
→ Here, MA99 highlights that the claim cannot be fully processed because the required Medigap information is incomplete or invalid.
3After billing a patient who has both Medicare and a Medigap policy, the provider receives an 835 with an adjustment noted alongside MA99.
→ The appearance of MA99 indicates that the adjustment is specifically due to issues with the Medigap information, necessitating a review and correction of the details provided.
What to Do
- Verify the Medigap information submitted with the claim for accuracy and completeness.
- Correct any inaccuracies in the Medigap policy details and resubmit the claim if necessary.
- Ensure that all required fields related to Medigap coverage are filled out on the claim form.
What to Check
- The original claim submission for completeness of Medigap information.
- The patient’s Medigap policy details to ensure they match the payer's requirements.
- Any documentation regarding the patient's Medigap coverage that may need to be submitted with the claim.