Skip to main content

MA109 Remark Code: Processed Under ASC Guidelines

MA109 means the claim was processed in accordance with ambulatory surgical center (ASC) guidelines, so ASC payment rules, not hospital or office rules, determined the result.

Quick facts

Code
MA109 (RARC MA109)
Status
Active In use since January 1, 1997.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): Adjustments reflect ASC payment rules and are the provider's responsibility under the contract.
  • PR (Patient Responsibility): Patient cost-sharing was calculated under ASC rules.
Official description
Claim processed in accordance with ambulatory surgical guidelines.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What MA109 means

MA109 is an informational remark saying the claim was processed under ambulatory surgical center (ASC) guidelines. ASCs are paid under their own payment system, with rules for which procedures are covered in that setting, how packaged items are handled, and how multiple procedures are reduced. The remark tells you those rules drove the payment on this claim.

Common causes

  • The claim came from an ASC, which is the normal case.
  • Place of service 24 was reported on a professional claim.
  • Facility information on the claim identified an ASC.

What to do

  1. Confirm the setting was an ASC and the place of service (CMS-1500 item 24B) and facility (item 32) are correct.
  2. Check reductions such as multiple procedure or packaging adjustments against ASC rules and your contract.
  3. Contact the payer if the payment does not match the ASC rate you expected.
  4. Correct and resubmit if the ASC setting was reported in error.

How to prevent problems

  • Keep place of service accurate for procedures that can be performed in more than one setting.
  • Maintain an ASC fee schedule in your system to compare payments.
  • Bundling and packaging rules are covered in NCCI and bundling denials.

Codes that may appear with MA109

  • CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): A fee schedule adjustment based on the ASC payment rate.
  • CO-59 (Processed based on multiple or concurrent procedure rules. (For example multiple surgery or diagnostic imaging, concurrent anesthesia.)): A reduction for multiple procedures, which ASC rules apply to many surgical procedures.
  • CO-97 (The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.): Items packaged into the ASC payment for the procedure and not paid separately.
  • M144 (Pre-/post-operative care payment is included in the allowance for the surgery/procedure.): Pre- and post-operative care included in the surgery allowance.
  • N428 (Not covered when performed in this place of service.): Not covered in this place of service.

MA109 FAQ

Is MA109 a denial?

No. It explains which payment rules were applied. Look at the CARCs for any reductions or denials.

Why would a physician see MA109?

Physician claims for procedures performed in an ASC use the ASC place of service, which can affect professional payment. MA109 may appear if the payer applied ASC-related rules.

What if the procedure was not done in an ASC?

Check the place of service and facility information on the claim. If they are wrong, correct and resubmit.