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M80 - Denial Journal
RARC

M80

What This Code Means

Not covered when performed during the same session/date as a previously processed service for the patient.

Common Causes

  • Service falls under a specific plan exclusion
  • Benefit maximum or occurrence limit already reached
  • Wrong plan or benefit category billed

How to Resolve or Appeal

  1. Confirm the specific exclusion or limit that applies with the payer
  2. Check for secondary coverage that may pick up the balance
  3. Bill the patient per financial policy if the exclusion is confirmed accurate

More Denial Codes to Check

CARC CO-78 CARC CO-303 CARC PR-204 Service/equipment/drug not covered under the patient's current benefit plan CARC CO-119 Benefit maximum for this time period or occurrence has been reached CARC CO-160 CARC CO-269 CARC CO-276 CARC CO-139 Contracted funding agreement — subscriber employed by the provider of services CARC CO-111 CARC CO-202

Educational reference only — not medical or legal advice. Always confirm code usage and appeal rights with the specific payer.

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