Reason Code 16 | Remark Codes M76 - JA DME
Reason Code 16 | Remark Codes M76
| Code | Description |
|---|---|
| Reason Code: 16 | Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. |
| Remark Codes: M76 | Missing/incomplete/invalid diagnosis or condition. |
Common Reasons for Denial
- Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. Missing/incomplete/invalid diagnosis or condition.
Next Step
- Verify the Local Coverage Determination (LCD), LCD Policy Article for the applicable diagnosis codes required for specific policies
- If no diagnosis, add diagnosis and rebill claim
- Suppliers may do a self service reopening in the Noridian Medicare Portal to change the diagnosis.
How to Avoid Future Denials
- Verify the Local Coverage Determination (LCD), LCD Policy Article for the applicable diagnosis codes required for specific policies, prior to billing
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