Top Claim Denial and Ways to Avoid the Denial in the Future

Are you receiving Reason Code 151 and Remark Code M3 denials on your Remittance Notice? Those indicate the equipment is the same or similar to equipment already being used. Do you know how to resolve these denials and prevent them from occurring in the future? Noridian has many tools to help providers in billing correctly such as the Denial Code Resolution Tool and Same or Similar Chart. Noridian also has self-service tools to help suppliers identify same or similar equipment prior to billing. These include the Noridian Medicare Portal and the Interactive Voice Response (IVR) – Self-Service Technology. By knowing if the beneficiary has similar equipment on file with Medicare, suppliers can issue an Advanced Beneficiary Notice of Non-Coverage (ABN) and bill utilizing the GA, GY or GZ modifier. As a reminder, same or similar denials can be appealed including all documentation requirements to support the need for a new/different piece of equipment.

 

            Last Updated Mon, 18 Apr 2022 16:40:04 +0000