Conquering Denial Code M119: Mastering NDC Accuracy for Better Reimbursement

Are you struggling with a rise in claim denials marked with Remark Code M119?
Remark Code M119 is a common denial reason, often due to errors related to the National Drug Code (NDC). Accurate NDC information is essential for proper billing and reimbursement. Mistakes can result in costly denials, delayed payments, and increased administrative workloads. Let’s explore the causes of M119 denials and how you can overcome them.

Understanding M119 Denials
Remark Code M119 indicates a significant problem with your NDC data. The NDC is a unique identifier crucial for billing and reimbursement. When the NDC information is incorrect or missing, it can lead to denied claims, delayed revenue, and added administrative burdens.

​Here are the most common reasons for M119 denials:

• Invalid NDC Format: The NDC must be in the 11-digit, 5-4-2 format (e.g., 00061-1415-02). Errors in the format can trigger denials.
• Outdated NDC: The code is no longer active or valid.
• Missing NDC Information: The NDC is absent from the claim.
• NDC Mismatch: The NDC does not match the administered drug.

Why M119 Denials Matter: The Financial Impact
M119 denials can have a severe impact on your practice’s bottom line. Denied claims not only result in lost revenue but can also increase administrative costs and trigger payer audits. Inaccurate NDC data can also affect patient satisfaction due to delays in payment processing and reimbursement.

Strategies to Prevent M119 Denials
To protect your practice’s revenue and streamline your billing processes, consider these strategies:

• Robust Pharmacy Inventory Management: Ensure all NDCs are up-to-date, accurate, and match the drugs administered.
• Data Validation: Use technology to verify NDC information before submitting claims.
• Staff Training: Educate your team about the importance of accurate NDC data entry to reduce errors.
• Regular Audits: Conduct internal audits to catch and correct errors before claims are submitted.
• Payer Compliance: Stay informed about payer-specific NDC requirements to avoid unexpected denials.
• Detailed Reporting: Regularly generate reports to monitor NDC-related data and identify potential issues early.

Optimize Your Revenue Cycle with Claims Med
Implementing these strategies can help you reduce M119 denials and enhance your practice's financial health. However, navigating the complexities of revenue cycle management requires specialized expertise. At Claims Med, we offer comprehensive revenue cycle management solutions tailored to healthcare providers. Our team is experienced in:

• Streamlining Billing Processes
• Improving Claim Accuracy
• Maximizing Reimbursement
• Recovering Lost Revenue

Don't let M119 denials disrupt your practice's success. Get in touch with Claims Med today to discover how our expertise can elevate your revenue cycle management and safeguard your financial future.

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