Reason Code B15 | Remark Code M51 - JD DME
Reason Code B15 | Remark Code M51
| Code | Description |
|---|---|
| Reason Code: B15 | This service/procedure requires that a qualifying service/procedure be received and covered. The qualifying other service/procedure has not been received/adjudicated. |
| Remark Codes: M51 | Missing/incomplete/invalid procedure code(s). |
Common Reasons for Denial
- Administration fee billed with no drug billed within required time frame
- Missing/incomplete/invalid "from" date(s) of service
Possible Next Step
- A Redetermination request may be submitted with all relevant supporting documentation. Noridian encourages Redeterminations/Appeals be submitted using the Noridian Medicare Portal. Review applicable Local Coverage Determination (LCD), LCD Policy Article, and Documentation Checklists prior to submitting request. Noridian encourages Redeterminations be submitted using the Noridian Medicare Portal.
- Suppliers may do a self-service reopening in the Noridian Medicare Portal to adjust place of service based on medical records available to supplier.
- Ensure drug billed is associated with administration fee.
- Was item eligible for coverage for date of service billed? May need to bill different program.
How to Avoid Future Denials
- Ensure LCD guidelines are met
- Ensure correct dates of service are billed
- Ensure administration fee is charged and billed within date of service for drug guidelines
- Ensure place of service is the same for drug and administration fee
Last Updated $dateUtil.getDate( $modifieddate , "MMM dd , yyyy" , $locale , $tzone )
