Article Detail - JD DME

A top denial on remittance advices continues to be Reason Code 16/Remark Code M124. As a reminder:

• Beneficiary-owned information must be on file with Medicare Fee-for-Service (FFS) to avoid denials.

Claims for supplies and accessories used with beneficiary-owned equipment must include three pieces of information with claim submission in the narrative section.

• HCPCS code of base equipment; and,
• A notation equipment is beneficiary-owned; and,
• Date beneficiary obtained equipment (approximate)

Example: Bene-owned E0601 pur Jan 2021

Once the beneficiary-owned item is placed on file, subsequent supply claims do not require a narrative.

If you continue to receive denials because the information still is not on file, please utilize the following options to ensure the information has been added to the beneficiary’s record.

• Call telephone reopening through the Supplier Contact Center
• Submit a written reopening using the Noridian Medicare Portal appeals process
• Mail
• Fax