How To Fix Remark Code M100 (RARC) | Common Reasons, Next Steps & How To Avoid It

Remark Code M122 means that there is a missing, incomplete, or invalid level of subluxation. This code is used to indicate the reason for denial or adjustment of a claim related to subluxation services. It is important to address this remark code to ensure accurate billing and proper reimbursement.

1. Description

Remark Code M122 signifies that there is a missing, incomplete, or invalid level of subluxation. The official description states: ‘Missing/incomplete/invalid level of subluxation.’ Subluxation refers to a partial dislocation or misalignment of a joint or vertebra. Proper documentation of the level of subluxation is crucial for accurate diagnosis and appropriate treatment planning.

2. Common Reasons

1. Missing level of subluxation: This occurs when the healthcare provider fails to document the specific level of subluxation in the medical records. Without this information, it becomes challenging to determine the severity and location of the subluxation.
2. Incomplete level of subluxation: Incomplete documentation of the level of subluxation may include insufficient details or ambiguous descriptions. This can lead to claim denials or adjustments as it hinders accurate coding and billing.
3. Invalid level of subluxation: An invalid level of subluxation refers to a documented level that does not align with the recognized coding guidelines or medical standards. This can result in claim denials or adjustments due to coding errors.

3. Next Steps

1. Review the medical records: Carefully examine the medical records to identify any missing, incomplete, or invalid level of subluxation documentation. Ensure that all necessary details are accurately recorded.
2. Consult with the healthcare provider: If there are any discrepancies or missing information, reach out to the healthcare provider to clarify and obtain the required documentation. Effective communication is essential for resolving coding and billing issues.
3. Update the medical records: Once the missing or incomplete information is obtained, update the medical records accordingly. Ensure that the level of subluxation is clearly documented and aligns with the recognized coding guidelines.

4. How To Avoid It

1. Thorough documentation: Healthcare providers should ensure that the level of subluxation is clearly documented in the medical records. Include specific details such as the affected joint or vertebra, the degree of misalignment, and any associated symptoms.
2. Follow coding guidelines: Familiarize yourself with the coding guidelines for subluxation services and ensure accurate coding based on the documented level of subluxation. Adhering to the guidelines helps prevent coding errors and subsequent claim denials.
3. Regular training and education: Stay updated with the latest coding and documentation requirements through regular training and education. This helps healthcare providers and coders maintain compliance and accuracy in coding and billing practices.

5. Example Cases

1. Case 1: A claim for subluxation services is denied because the medical records do not specify the level of subluxation, highlighting the importance of thorough documentation.
2. Case 2: A claim adjustment occurs due to an invalid level of subluxation documented, emphasizing the need for accurate coding based on recognized guidelines.

Source: Remittance Advice Remark Codes