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M25 - Denial Journal
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RARC

M25

RARC Medical Necessity
Quick Facts
Code
M25
Type
RARC
Category
Medical Necessity
Status
Active

Information furnished does not substantiate the need for this level of service

What Does This Code Mean?

The documentation submitted doesn’t support the specific level of service that was billed.

Common Causes

  • Notes don't reflect the complexity/time required for the billed level
  • Supporting documentation not submitted with the claim

Recommended Next Steps

  1. Review documentation against the requirements for that level of service
  2. Appeal with complete documentation, or resubmit at a supportable level

Related Codes

CARC CO-150

More Denial Codes to Check

CARC CO-153 CARC CO-261 CARC CO-56 RARC M42 CARC CO-57 CARC CO-150 RARC N362 CARC CO-50 CARC CO-154 CARC CO-55

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

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