Postoperative Care/Bundled Services - JF Part B
Postoperative Care / Bundled Services
| CARC/RARC | Description |
|---|---|
| CO-97 | The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
| M15 | Separately billed services/tests have been bundled as they are considered components of the same procedure. Separate payment is not allowed. |
Common Reasons for Message
- A separate charge is not allowed because this service is part of major surgical (90 global days) procedure
Next Step
- Verify that surgery was billed correctly and includes appropriate modifiers
- Previous surgery date can be found using the Noridian Medicare Portal (NMP)
- A reopening can be performed to add appropriate modifiers
- Submit an Appeal request - Items or services with this message have appeal rights
- Submit documentation with Redetermination request. View Medical Documentation Requirements
Claim Submission Tips
- Follow instructions on correct use of Modifiers
Last Updated Dec 09 , 2023
