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M127 Remark Code: Missing Patient Medical Record

M127 means the patient medical record for this service was missing. The payer required the record to decide the claim and did not have it, so payment is withheld or denied until documentation is supplied.

Quick facts

Code
M127 (RARC M127)
Status
Active In use since January 1, 1997; last modified February 28, 2003.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The service is unpaid pending documentation. The provider is responsible for sending records; the patient is not billed.
Official description
Missing patient medical record for this service.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What M127 means

Some services cannot be paid on claim data alone. The payer needs to read the patient’s medical record to confirm the service was performed, necessary, and billed correctly. M127 tells you the record for this service was required and did not reach the payer.

Unlike N237, which says records arrived but were insufficient, M127 means the payer has nothing to review.

Common causes

  • A records request sent to an old address or to the wrong department.
  • Records sent without a claim number or cover sheet, so they were never matched.
  • A payer policy requiring records with the initial claim for certain services, such as unlisted procedures.
  • Missed deadlines on additional documentation requests.

How to fix it

  1. Find out what was requested and by when, through the portal or payer correspondence.
  2. Assemble the records for the date of service, including anything specifically asked for.
  3. Submit them by the payer’s accepted method, clearly referencing the claim number and patient.
  4. Resubmit the claim with an attachment indicator if the payer requires a new claim.
  5. Track the claim until it is reprocessed.

How to prevent it

  • Keep correspondence addresses current with each payer.
  • Log every documentation request with its due date and assign an owner.
  • Send documentation proactively for services that routinely require it.
  • Monitor attachment-related denials with an ERA Analyzer.

For more on missing information, see the CO-16 guide.

Codes that may appear with M127

  • CO-252 (An attachment/other documentation is required to adjudicate this claim/service.): An attachment or other documentation is required to adjudicate the service.
  • CO-226 (Information requested from the Billing/Rendering Provider was not provided or not provided timely or was insufficient/incomplete.): Requested information was not provided, not timely, or incomplete.
  • CO-16 (Claim/service lacks information or has submission/billing error(s).): Some payers still report missing records as a general missing-information rejection.
  • N237 (Incomplete/invalid patient medical record for this service.): The medical record was received but was incomplete or invalid.
  • N366 (Requested information not provided.): The claim can be reopened if the requested information is submitted within the stated period.
  • M135 (Missing/incomplete/invalid plan of treatment.): Specifically the plan of treatment was missing or invalid.

M127 FAQ

What records should I send?

The notes for the date of service that support the service billed, such as the visit or procedure note, orders, and results. The payer's request may list specific items.

How do I send records?

Use the payer's accepted method: electronic attachment, portal upload, fax, or mail, referencing the claim number.

Do I need a new claim?

Sometimes. Some payers reprocess the original claim when records arrive; others require a new submission with the attachment. Check the payer's instructions.