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M138 - Denial Journal
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RARC

M138

RARC Eligibility
Quick Facts
Code
M138
Type
RARC
Category
Eligibility
Status
Active

What Does This Code Mean?

Patient identified as a demonstration participant but not enrolled at the time services were rendered.

Common Causes

  • Patient's coverage wasn't active on the date of service
  • Wrong member ID or plan information submitted
  • Dependent/relationship status not up to date with the payer

Recommended Next Steps

  1. Re-verify eligibility for the exact date of service
  2. Confirm member ID and plan details directly with the patient or payer
  3. Bill any other active coverage found, or the patient per financial policy

More Denial Codes to Check

CARC CO-140 CARC CO-141 CARC CO-100 CARC CO-52 CARC CO-13 CARC CO-177 CARC CO-34 CARC CO-31 CARC B9 CARC CO-184 CARC CO-27

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

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