How To Fix Remark Code M37 (RARC) | Common Reasons, Next Steps & How To Avoid It
Remark Code M42 means that the medical necessity form must be personally signed by the attending physician. This code is used to indicate that the required signature on the medical necessity form is missing or not provided by the attending physician. It is important for healthcare providers and coders to understand this remark code to ensure proper documentation and billing.
1. Description
Remark Code M42 indicates that the medical necessity form must be personally signed by the attending physician. The official description states: ‘The medical necessity form must be personally signed by the attending physician.’ This remark code emphasizes the importance of obtaining the attending physician’s signature on the medical necessity form to support the need for the provided services.
2. Common Reasons
- Missing signature on the medical necessity form: One of the most common reasons for Remark Code M42 is the absence of the attending physician’s signature on the medical necessity form. This can occur due to oversight or incomplete documentation.
- Signature provided by a non-attending physician: If the medical necessity form is signed by a physician who is not the attending physician, it will result in Remark Code M42. The attending physician’s signature is crucial to validate the medical necessity of the services provided.
- Illegible or incomplete signature: In some cases, the attending physician’s signature may be illegible or incomplete, making it difficult to verify the authenticity of the signature. This can lead to Remark Code M42.
3. Next Steps
- Contact the attending physician for a signed medical necessity form: If the medical necessity form is missing the attending physician’s signature, it is essential to reach out to them to obtain the required signature. This can be done through direct communication or by sending the form for their signature.
- Ensure the medical necessity form is complete: Review the medical necessity form to ensure that all required fields are filled out accurately. This includes verifying that the attending physician’s signature is clear and legible.
- Document the communication and actions taken: Keep a record of all communication with the attending physician regarding the missing signature. Document any steps taken to obtain the signature, such as sending reminders or follow-up emails.
4. How To Avoid It
- Educate attending physicians on the importance of signing the medical necessity form: Provide clear guidelines and instructions to attending physicians regarding the necessity of their signature on the medical necessity form. Emphasize the impact it has on proper documentation and billing.
- Implement a process for verifying the completeness of the medical necessity form: Develop a checklist or system to ensure that all required fields, including the attending physician’s signature, are completed before submitting the form.
- Regularly review and update documentation policies: Stay updated with any changes in documentation requirements and policies. Regularly review and revise internal processes to align with the latest guidelines.
5. Example Cases
- Case 1: A claim is denied due to Remark Code M42 because the attending physician’s signature is missing on the medical necessity form. The healthcare provider contacts the physician, obtains the signature, and resubmits the claim for processing.
- Case 2: A claim adjustment occurs because the medical necessity form is signed by a non-attending physician, resulting in Remark Code M42. The healthcare provider educates the staff on the importance of obtaining the attending physician’s signature to avoid similar issues in the future.
Source: Remittance Advice Remark Codes
