Encountering Remark Code M119 on your medical claims can significantly impact your practice’s bottom line. This code indicates issues with your National Drug Code (NDC) information, a critical element for accurate billing and reimbursement. Errors in NDC data can lead to claim denials, delayed payments, and increased administrative burdens.
Understanding Remark Code M119
Remark Code M119 signals a problem with the NDC information submitted on your claim. The NDC, a unique 11-digit identifier (formatted as 5-4-2), is essential for identifying and tracking medications. Common causes of M119 denials include:
- Invalid NDC Format: Incorrect number of digits or an incorrect structure (e.g., incorrect hyphenation).
- Outdated NDC: The NDC may no longer be active or valid due to medication updates or manufacturer changes.
- Missing NDC Information: The NDC may be missing from the claim altogether.
- NDC Mismatch: The NDC on the claim may not accurately reflect the medication actually administered to the patient.
The High Cost of M119 Denials
M119 denials have a significant financial impact:
- Lost Revenue: Denied claims directly translate to lost revenue, impacting your practice’s profitability.
- Increased Administrative Costs: Resubmitting claims, handling denials, and gathering supporting documentation consume valuable time and resources.
- Audits and Penalties: Frequent M119 denials may trigger audits from payers, potentially resulting in penalties and fines.
- Erosion of Patient Trust: Delayed or denied claims can lead to patient frustration and dissatisfaction.
Strategies to Prevent M119 Denials
To minimize the impact of M119 denials:
- Robust Pharmacy Inventory Management: Maintain an accurate and up-to-date inventory of all medications with their corresponding NDCs.
- Data Validation: Implement robust data validation checks within your electronic health record (EHR) system and billing software to identify and correct NDC errors before claim submission.
- Staff Training: Educate your staff, including physicians, nurses, and billing personnel, on the importance of accurate NDC data entry and the potential consequences of errors.
- Regular Audits: Conduct regular internal audits of your billing data to identify and address any patterns of NDC-related errors.
- Payer Compliance: Stay informed about payer-specific rules and regulations regarding NDC usage and submission.
Optimize Your Revenue Cycle with Claims Med
Minimizing M119 denials requires a multifaceted approach. Claims Med offers specialized revenue cycle management solutions to help you:
- Streamline Billing Processes: Optimize your workflows to ensure accurate and timely claim submissions.
- Improve Claim Accuracy: Identify and address potential issues with your claims data, including NDC errors.
- Maximize Reimbursement: Increase your claim acceptance rates and optimize reimbursement for your services.
- Recover Lost Revenue: Effectively appeal denied claims and recover lost revenue due to M119 denials.
Don’t let M119 denials hinder your practice’s financial success. Contact Claims Med today to learn how our expertise can help you optimize your revenue cycle and improve your bottom line.