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M92 Remark Code (Deactivated): Home Health Medical Review

M92 told a provider that the services had been subjected to review under Medicare's Home Health Medical Review Initiative. X12 deactivated it without naming a replacement; M95, which covers Home Health Initiative medical review or cost report audit, is the closest active remark.

X12 deactivated RARCM92 on August 1, 2004. Payers should no longer use it on new remittances, but it can still appear on older ERAs, corrected claims, and appeals.

Code: M92 (RARC M92)
Status: Deactivated StoppedAugust 1, 2004 (in use since January 1, 1997).
Code set: Remittance Advice Remark Codes (RARC)
Group codes: CO (Contractual Obligation): Usually accompanied CO adjustments resulting from the review; the agency bore any reduction.
Official description: Services subjected to review under the Home Health Medical Review Initiative.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What M92 meant

Remark M92 was informational context for home health agencies. It told the agency that its services were reviewed under a Medicare medical review initiative focused on home health. Whatever happened to the payment was shown by the adjustment codes; M92 simply explained that a targeted review was the reason the claim got extra scrutiny.

What replaced it

X12 did not name a successor. The nearest active remark is M95, which says services were subjected to Home Health Initiative medical review or a cost report audit. Review outcomes are expressed with CARCs such as CO-216 for findings of a review organization or CO-50 for medical necessity.

If you still see M92

It belongs to historical home health remittances. If you are working through old reviewed claims, focus on the paired adjustment code and the review letter. For current reviews, keep the certification, plan of care, face-to-face documentation, and visit notes organized so you can answer record requests quickly.

M95 (Services subjected to Home Health Initiative medical review/cost report audit.): Services subjected to Home Health Initiative medical review or cost report audit.
CO-216 (Based on the findings of a review organization or the payer's findings.): Adjustment based on the findings of a review organization or the payer.
CO-50 (These are non-covered services because this is not deemed a 'medical necessity' by the payer.): Not deemed a medical necessity by the payer, a common review outcome.

M92 FAQ

Was M92 a denial by itself?

No. It explained that the claim had gone through a medical review program. Any denial or reduction was stated by the adjustment codes on the same line.

What could a home health agency do after such a review?

Review the determination against the plan of care and visit documentation, and use the Medicare appeal process if the records support the services billed.

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