How To Fix Remark Code M150 (RARC) | Common Reasons, Next Steps & How To Avoid It

Remark Code MA35 means that there is a missing, incomplete, or invalid number of lifetime reserve days. This code is used to indicate the reason for denial or adjustment of a claim related to the number of lifetime reserve days available for a patient’s hospital stay.

1. Description

Remark Code MA35 indicates that there is an issue with the number of lifetime reserve days associated with a patient’s hospital stay. The official description states: ‘Missing/incomplete/invalid number of lifetime reserve days.’ Lifetime reserve days are an additional set of hospital days that Medicare beneficiaries have available for use after exhausting their regular Medicare benefits. These reserve days are typically used for extended hospital stays or for situations where additional care is required.

2. Common Reasons

1. Missing number of lifetime reserve days: This may occur when the number of lifetime reserve days available for the patient’s hospital stay is not provided or is not accurately documented.
2. Incomplete number of lifetime reserve days: This can happen when the documentation regarding the number of lifetime reserve days is incomplete or lacks necessary details.
3. Invalid number of lifetime reserve days: An invalid number of lifetime reserve days may be reported if the provided information does not match the patient’s eligibility or if there are discrepancies in the calculation of the available reserve days.

3. Next Steps

1. Contact the healthcare provider or facility: Reach out to the healthcare provider or facility to obtain the missing or corrected information regarding the number of lifetime reserve days.
2. Review the patient’s medical records: Thoroughly review the patient’s medical records to ensure that the documentation accurately reflects the number of lifetime reserve days available for the hospital stay.
3. Coordinate with the patient’s insurance company: Communicate with the patient’s insurance company to clarify any discrepancies or resolve issues related to the number of lifetime reserve days.

4. How To Avoid It

1. Ensure accurate documentation: It is crucial to accurately document the number of lifetime reserve days available for the patient’s hospital stay.
2. Verify eligibility and benefits: Confirm the patient’s eligibility and benefits with the insurance company to ensure that the correct number of lifetime reserve days is applied.
3. Double-check calculations: Double-check the calculations to ensure that the number of lifetime reserve days is accurately determined based on the patient’s previous hospital stays and utilization.

5. Example Cases

1. Case 1: A claim for a patient’s extended hospital stay is denied due to a missing number of lifetime reserve days. The healthcare provider contacts the insurance company to provide the necessary documentation, and the claim is subsequently approved.
2. Case 2: A claim adjustment occurs because the number of lifetime reserve days reported is invalid. The healthcare provider reviews the patient’s medical records, identifies the error, and submits a corrected claim with the accurate number of lifetime reserve days.

Source: Remittance Advice Remark Codes