Remark code M59 indicates that the claim submitted lacks a complete or valid 'to' date of service, or such information is entirely missing. This means that the date when the healthcare services ended has not been properly documented on the claim form, which is necessary for proper claims processing and reimbursement.
Common causes of code M59 are typically related to errors or omissions in the billing process where the 'to' date of service on a claim is either not provided, incorrectly entered, or does not match the duration of service as documented in the patient's medical records. This can occur due to manual data entry mistakes, misinterpretation of the dates services were provided, or discrepancies between the claim form and the electronic medical records. Additionally, it may result from a misunderstanding of billing guidelines for services that span multiple days or from software issues that prevent the correct 'to' date from populating on the claim. Ensuring accurate and complete documentation, as well as thorough verification processes, can help prevent this type of error.
Ways to mitigate code M59 include implementing a robust claim scrubbing process that checks for the completeness and accuracy of all date fields before submission. Ensure that your billing software automatically flags claims with missing or invalid 'to' dates. Train your billing staff to double-check dates of service for accuracy and completeness during the charge entry process. Establish a protocol for cross-referencing the dates of service on claims with the corresponding dates documented in the patient's electronic health record (EHR). Regularly audit a sample of claims to identify and address any recurring issues with date entries.
The steps to address code M59 involve a thorough review of the claim to identify where the 'to' date(s) of service may be missing, incomplete, or invalid. Begin by cross-referencing the claim with the patient's medical records to verify the actual service dates. Once the correct 'to' date(s) are confirmed, update the claim form with the accurate information. Ensure that the date format follows the payer's specifications, typically in MMDDYYYY format. After making the necessary corrections, resubmit the claim to the payer for processing. It's also advisable to check if the 'from' date(s) are accurate to prevent any further issues with the claim. Implement a process to double-check dates of service before initial submission to minimize the recurrence of this error.