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Reason Code 50 | Remark Code M127 - JD DME

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 Thu, 20 Apr 2023 15:46:09 +0000