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MA122 Remark Code: Initial Treatment Date Missing

MA122 means the claim was missing, or had an incomplete or invalid, initial treatment date. Payers use it to identify when a course of treatment began, which affects limits and medical necessity reviews.

Quick facts

Code
MA122 (RARC MA122)
Status
Active In use since January 1, 1997; last modified December 2, 2004.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The service was not paid because the initial treatment date was missing or invalid. The provider corrects it; the patient is not billed.
Official description
Missing/incomplete/invalid initial treatment date.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What MA122 means

MA122 says the initial treatment date, the date the current course of treatment began, was missing, incomplete, or invalid. Payers commonly require it on chiropractic claims and on some therapy claims, where it helps them track episodes of care and decide whether ongoing treatment is still appropriate.

It typically comes with CARC 16.

Common causes

  • The date was left out of item 14 or the electronic claim.
  • The date of current illness was entered instead of the treatment start date, or with the wrong qualifier.
  • The initial treatment date is after the date of service.
  • A new episode began but the old start date was carried forward.

How to fix it

  1. Confirm the start date of the current course of treatment from the record.
  2. Enter it in item 14 or the 837 date segment, per payer instructions. Medicare does not use the item 14 qualifier; other payers may require one.
  3. Check consistency with the x-ray date and date of service.
  4. Resubmit the corrected claim, using resubmission code 7 in item 22 if replacing a processed claim.

How to prevent it

  • Record the start of each episode of care in the patient’s chart and billing profile.
  • Reset the initial treatment date when a new condition or episode begins.
  • For missing-data denials in general, see CO-16 missing information denials.

Codes that may appear with MA122

  • CO-16 (Claim/service lacks information or has submission/billing error(s).): The claim lacks required information, identified by MA122 as the initial treatment date.
  • MA121 (Missing/incomplete/invalid x-ray date.): The x-ray date, also used on chiropractic claims.
  • MA100 (Missing/incomplete/invalid date of current illness or symptoms.): The date of current illness or symptoms.
  • N334 (Missing/incomplete/invalid re-evaluation date.): A missing or invalid re-evaluation date.

MA122 FAQ

Where does the initial treatment date go?

For Medicare chiropractic claims, the CMS-1500 instructions use item 14 for the date the current course of treatment began. Medicare says not to enter a qualifier in item 14. Other payers may use different instructions.

Is the initial treatment date the first visit ever?

No. It is the start of the current course of treatment for the condition billed. A new condition or episode can have a new initial treatment date.

Why does it matter?

Payers use it to track episodes of care and apply limits or reviews based on how long treatment has continued.