How To Fix Remark Code M187 (RARC) | Common Reasons, Next Steps & How To Avoid It

Remark Code MA76 means that there is a missing, incomplete, or invalid provider identifier for a home health agency or hospice when a physician is performing care plan oversight services. This code is used to indicate the reason for denial or adjustment of a claim related to care plan oversight services provided by a physician in conjunction with a home health agency or hospice.

1. Description

Remark Code MA76 indicates that there is an issue with the provider identifier for a home health agency or hospice when a physician is performing care plan oversight services. The official description states: ‘Missing/incomplete/invalid provider identifier for home health agency or hospice when physician is performing care plan oversight services.’ This remark code highlights the importance of accurate and complete provider identification for proper billing and reimbursement.

2. Common Reasons

1. Missing provider identifier: The claim may be denied or adjusted if the provider identifier for the home health agency or hospice is missing from the claim.
2. Incomplete provider identifier: If the provider identifier for the home health agency or hospice is incomplete or contains errors, the claim may not be processed correctly.
3. Invalid provider identifier: If the provider identifier for the home health agency or hospice is not recognized or does not match the information on file, the claim may be denied or adjusted.

3. Next Steps

1. Verify the provider identifier: Check the provider identifier for the home health agency or hospice to ensure it is complete, accurate, and valid.
2. Contact the home health agency or hospice: If the provider identifier is missing or incomplete, reach out to the home health agency or hospice to obtain the correct information.
3. Update the claim: If the provider identifier is invalid, update the claim with the correct and valid provider identifier before resubmitting.

4. How To Avoid It

1. Double-check provider identifiers: Take the time to verify and validate the provider identifiers for home health agencies and hospices before submitting claims.
2. Ensure complete and accurate information: Provide all necessary information for the provider identifier, including any required prefixes or suffixes.
3. Stay up-to-date with provider changes: Regularly review and update provider information to ensure it is current and valid.

5. Example Cases

1. Case 1: A claim for care plan oversight services is denied because the provider identifier for the home health agency is missing, emphasizing the importance of complete documentation.
2. Case 2: A claim adjustment occurs because the provider identifier for the hospice is invalid, highlighting the need for accurate and valid provider information.

Source: Remittance Advice Remark Codes