Remark Code M14 means that there will be no separate payment for an injection administered during an office visit, and no payment for a full office visit if the patient only received an injection. This code is used to indicate the reason for denial or adjustment of a claim related to injections and office visits.
1. Description
Remark Code M14 indicates that no separate payment will be made for an injection administered during an office visit, and there will be no payment for a full office visit if the patient only received an injection. The official description states: ‘No separate payment for an injection administered during an office visit, and no payment for a full office visit if the patient only received an injection.’ This remark code highlights the importance of proper coding and billing practices when it comes to injections and office visits.
2. Common Reasons
- Injection billed separately from the office visit: This remark code may be triggered when an injection is billed as a separate service from the office visit, resulting in no separate payment for the injection.
- Patient only received an injection: If the patient only received an injection during the visit and no other services were provided, there will be no payment for a full office visit.
- Incorrect coding or documentation: If the coding or documentation does not accurately reflect the services provided, it may result in the denial or adjustment of the claim.
3. Next Steps
- Review the billing and coding practices: Ensure that injections and office visits are coded and billed correctly, following the guidelines and requirements set forth by the payer.
- Verify the documentation: Double-check the documentation to ensure that it accurately reflects the services provided during the visit, including any injections administered.
- Consider bundling the injection with the office visit: If the injection is an integral part of the office visit and not separately billable, it may be appropriate to bundle the services together for proper reimbursement.
4. How To Avoid It
- Understand the payer’s guidelines: Familiarize yourself with the specific guidelines and policies of the payer regarding injections and office visits to ensure accurate coding and billing.
- Code and bill correctly: Ensure that the injection and office visit are coded correctly, following the appropriate coding guidelines and using the correct codes for the services provided.
- Document the services accurately: Thoroughly document the services provided during the visit, including the administration of any injections, to support proper billing and reimbursement.
5. Example Cases
- Case 1: A claim for an office visit and a separate injection is denied because the injection was billed as a separate service instead of being bundled with the office visit.
- Case 2: A claim for a full office visit is adjusted because the patient only received an injection during the visit, resulting in no payment for the office visit.
