How do I fix a claim that denied CO-176 with remark code M60 – “Payment denied because the prescription is not current,” when billing a claim for oxygen equipment?
This denial is usually due to a missing recertification CMN on file. For group one oxygen patients, a recert CMN is due 12 months after the initial date. For group 2 oxygen patients, a recert CMN is due three months after the initial date. If there is previous oxygen equipment on file, and there was a break in service due to a change in medical need greater than 60 days plus the days remaining in the last rental month, then resubmit your claim with your initial CMN and include the break in service information in the claim narrative. Otherwise, a recert CMN will be needed in order to continue payment for oxygen.
Related Questions
- Why would my claim deny CO-16 (Remark code MA114, claim service lacks information which is needed for adjudication. Missing/incomplete/invalid information on where the services were furnished)?
- I have an outpatient claim that denied with reason code C7050 because the dates of service fall within the dates of service of an inpatient hospital claim. What do I do?
- I am receiving a CO-176 denial (payment is denied because prescription is not current). Why?
