M20
RARC (Medicare)
HCPCS code missing or invalid
A HCPCS code (supplies, drugs, DME or a payer-required code) is missing, not valid for the date, or incomplete.
Usual causes
- Deleted or new HCPCS code (quarterly updates).
- Revenue code billed without the required HCPCS on an institutional claim.
- Typo in the code.
The fix
Look up the valid code for the date of service and resubmit.
Appeal or corrected claim?
Corrected claim
Corrected claim.
Deadline to watch
Timely filing limit.
Exact limits are in your payer contract or provider manual. When in doubt, send the correction or appeal this week.
Questions
M20 in short
What does M20 mean?
A HCPCS code (supplies, drugs, DME or a payer-required code) is missing, not valid for the date, or incomplete. The official X12 text reads: "Missing/incomplete/invalid HCPCS."
What usually causes a M20 denial?
Deleted or new HCPCS code (quarterly updates). Revenue code billed without the required HCPCS on an institutional claim. Typo in the code.
How do I fix M20?
Look up the valid code for the date of service and resubmit.
Should I appeal M20 or send a corrected claim?
Corrected claim. Corrected claim.
What deadline applies to M20?
Timely filing limit.