Reason Code 16 | Remark Code M51 - JA DME

Common Reasons for Denial

• Item billed was missing or had an incomplete/invalid procedure code and or modifiers

Next Step

• Correct claim and resubmit claim with a valid procedure code and or modifiers

How to Avoid Future Denials

• Ensure that all claim lines have a valid procedure code and or modifiers prior to billing for the date of service billed
• Update software systems as necessary to ensure claims are billed with current procedure code and or modifiers