Remark code MA90 is an indication that the claim submitted lacks a valid employment status code for the primary insured, or the information provided is either incomplete or missing altogether. This code alerts the healthcare provider that additional information regarding the primary insured's employment status is required to process the claim effectively.
Common causes of code MA90 are:
1. Incorrect or outdated information in the patient's insurance file regarding the primary insured's employment status.
2. Data entry errors when inputting the primary insured's employment information into the billing system.
3. Failure to update the primary insured's employment status following a change in their employment situation, such as starting a new job, unemployment, or retirement.
4. Inadequate verification of the primary insured's employment details during the patient registration or check-in process.
5. Omission of the employment status code altogether during the claim submission process.
6. Mismatch between the employment status information on the claim form and the records maintained by the insurance payer.
7. Use of outdated or incorrect coding on the claim form that does not align with the current standards or requirements set by the payer.
8. Systematic issues within the healthcare provider's practice management software that may prevent the correct employment status code from being captured or transmitted.
Ways to mitigate code MA90 include ensuring that the employment status of the primary insured is accurately captured and clearly documented in the patient's file before submitting the claim. Regularly update and verify the employment information during patient registration or check-in processes. Implement a double-check system where a second staff member reviews the employment status code for accuracy. Additionally, utilize electronic health record (EHR) systems with built-in alerts to flag missing or incomplete employment status fields prior to claim submission. Training staff on the importance of this data and the common errors that lead to code MA90 can also help reduce the occurrence of this issue.
The steps to address code MA90 involve verifying the employment status of the primary insured. Begin by reviewing the patient's file and insurance form to ensure that the employment status has been accurately captured and recorded. If the information is missing or incorrect, reach out to the patient or the employer to obtain the correct details. Update the insurance claim with the valid employment status code and resubmit the claim to the payer. Ensure that all documentation supporting the employment status, such as an employment verification letter, is readily available in case the payer requests further evidence. It's also advisable to check if your practice management system can flag such issues before submission to prevent future occurrences of this error.