How do I resolve a CO-16+M124 denial?

Beneficiary owned information must be on file with Medicare for base item in order to qualify for accessories or supplies. Information required: Beneficiary owned item HCPCS; approximate purchased month and year Good example: Bene-owned E0601 pur Jan 2023 (approximate) Methods to Place Information on File for Claims Processing If a denial is received with Reason Code 16, Remark Code M124 Contact the Supplier Contact Center to request a telephone reopening Request beneficiary owned equipment information be placed on file for base item for the accessories or supplies being billed If telephone reopening is unavailable, supplier contact center will provide guidance on next step to resolve Submit appeal/redetermination through the NMP appeals process when required (supplier contact center will provide that guidance) Review claim, was narrative entered for beneficiary owned base item? If answer is no, and claim denied as unprocessable, add required beneficiary information to claim and resubmit as new claim. This does not add beneficiary owned equipment information to history for beneficiary on subsequent claims and will need to be added through telephone reopenings Written reopening NMP appeals process Mail Fax Add required information to the narrative of every claim line for supplies used with base item not on file with Medicare until item has been placed on file Item 19 of the 1500 claim form or the 2400/NTE segment of an electronic claim. Claims lacking any one of the elements above will be denied for missing information. Once the beneficiary-owned item is placed on file, subsequent supply claims do not require a narrative.

835 Denial Combination

CO-16+M124

Contractual Obligation · Service-Line Level Adjustment

What This Combination Means

Item billed does not have base equipment on file. Main equipment is missing therefore Medicare will not pay for accessories or supplies. Suppliers must ensure that the beneficiary-owned equipment information is on file with Medicare Fee- for-Service (FFS) to avoid denials. This normally occurs when base item is provided prior to becoming Medicare eligible. Examples of items beneficiary owned are Positive Airway Pressure (PAP) devices, BiPAPs, nebulizers, all glucose monitors, and humidifiers, etc.

N/A

Appeal Success

7-14 days

Avg. Resolution

Medium

Difficulty

Appealable

Step-by-Step Resolution

Steps tailored specifically to this CO-16+M124 combination — not generic advice.

1
Beneficiary owned information must be on file with Medicare for base item in order to qualify for accessories or supplies.
2
Information required:
3
Beneficiary owned item HCPCS; approximate purchased month and year
4
Good example: Bene-owned E0601 pur Jan 2023 (approximate)
5
Methods to Place Information on File for Claims Processing
6
If a denial is received with Reason Code 16, Remark Code M124
7
Contact the Supplier Contact Center to request a telephone reopening
8
Request beneficiary owned equipment information be placed on file for base item for the accessories or supplies being billed
9
If telephone reopening is unavailable, supplier contact center will provide guidance on next step to resolve
10
Submit appeal/redetermination through the NMP appeals process when required (supplier contact center will provide that guidance)
11
Review claim, was narrative entered for beneficiary owned base item?
12
If answer is no, and claim denied as unprocessable, add required beneficiary information to claim and resubmit as new claim. This does not add beneficiary owned equipment information to history for beneficiary on subsequent claims and will need to be added through telephone reopenings
13
Written reopening
14
NMP appeals process
15
Mail
16
Fax
17
Add required information to the narrative of every claim line for supplies used with base item not on file with Medicare until item has been placed on file
18
Item 19 of the 1500 claim form or the 2400/NTE segment of an electronic claim. Claims lacking any one of the elements above will be denied for missing information.
19
Once the beneficiary-owned item is placed on file, subsequent supply claims do not require a narrative.

Specialty Context

How CO-16+M124 typically presents across different practice types.

Dental

Medical

Behavioral Health

Individual Code References

View the standalone definition for each code in this combination.

CARC 16 RARC M124

Medicare Contractor Guidance for CARC 16

FCSO + Noridian + uhc + aetna + bcbs_az

This RUC is received when a claim is submitted with missing, incorrect, or invalid information. For details pertaining to your claim, please refer to the remittance advice remark codes (RARCs) on the remittance advice (RA).

How to Prevent CARC 16 Denials

✓
Review the RARC on the remittance advice to identify which specific field has the error.
✓
Per Medicare guidelines, claims must be filed no later than 12 months after the date of service. RUCs are not considered filed/submitted.

CMS guidelines for completion of form CMS-1500 in the Medicare Claims Processing Manual (100-04), Chapter 26SPOTFee Schedule Lookup ToolCMS laboratory demographics lookupModifier lookup toolNoridian Medicare PortalNMPIVRSame or SimilarPECOSPDAC

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