Reason Code 50 | Remark Code M127

Code Description
Reason Code: 50 These are non-covered services because this is not deemed a 'medical necessity' by the payer.
Remark Code: M127 Missing patient medical record for this service.


Common Reasons for Denial

  • Documentation requested was not received or was not received timely
  • Added ST or KV modifier and an affirmative UTN to claim line, which initiated a prepayment review. Documentation requested was not received

Next Step

How to Avoid Future Denials

  • Respond to development letters with supporting documentation within designated timeline as defined on letter
  • When an affirmative UTN has been received, only append the UTN, do not append the ST or KV modifier for an acute or emergent situation


Last Updated Dec 09 , 2023