Skip to main content

MA16 Remark Code: Bill the Federal Black Lung Program

MA16 means the patient is covered by the federal Black Lung Program, and the claim must be sent to the Department of Labor's Federal Black Lung Program rather than to this payer. The payer will not pay services that program is responsible for.

Quick facts

Code
MA16 (RARC MA16)
Status
Active In use since January 1, 1997.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The provider must redirect the claim to the Black Lung Program. The patient should not be billed while that coverage applies.
  • OA (Other Adjustment): Some payers report this as another-payer adjustment, pointing you to the correct program.
Official description
The patient is covered by the Black Lung Program. Send this claim to the Department of Labor, Federal Black Lung Program, P.O. Box 828, Lanham-Seabrook MD 20703.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What MA16 means

MA16 is a wrong-payer notice with a specific destination. The payer, usually Medicare, has records showing that the patient is covered by the Federal Black Lung Program. For treatment of the covered condition, that program is responsible, so this payer declines the claim and tells you to bill the Department of Labor.

The official code text includes a Department of Labor mailing address, which the payer renders from the code itself.

Common causes

  • The diagnosis on the claim relates to a lung condition covered under the patient’s Black Lung benefits.
  • The patient’s Black Lung coverage was not recorded at registration.
  • The claim combined covered black lung treatment with unrelated services.

How to fix it

  1. Confirm the coverage. Ask the patient for their Black Lung Program information and verify eligibility.
  2. Review the diagnoses in box 21. Decide which services relate to the covered condition and which do not.
  3. Bill the Black Lung Program for the related services using its current provider billing instructions.
  4. Rebill unrelated services to the original payer with diagnoses that reflect the actual reason for the visit.
  5. Appeal if the link is wrong. If none of the services relate to the covered condition, contact the payer and request reprocessing.

How to prevent it

Ask about federal and occupational coverage during registration, especially for patients receiving pulmonary care, and store it with the patient’s insurance record. Payer-order problems are discussed in eligibility and COB denials.

Codes that may appear with MA16

  • CO-109 (Claim/service not covered by this payer/contractor.): The service is not covered by this payer and must be sent to the correct payer, the core message behind MA16.
  • OA-22 (This care may be covered by another payer per coordination of benefits.): The care may be covered by another payer under coordination of benefits.
  • OA-19 (This is a work-related injury/illness and thus the liability of the Worker's Compensation Carrier.): The injury or illness is work-related and is the liability of a workers' compensation carrier.
  • CO-B11 (The claim/service has been transferred to the proper payer/processor for processing.): The payer transferred the claim to the proper payer itself.
  • N598 (Health care policy coverage is primary.): Another health care policy's coverage is primary.

MA16 FAQ

What is the Black Lung Program?

It is a federal program administered by the U.S. Department of Labor that covers treatment of coal-mine dust lung disease for eligible former miners.

Does MA16 apply to all of the patient's care?

Not necessarily. The program covers treatment for the approved black lung condition. Unrelated care is generally billed to the patient's other coverage.

Where do I send the claim?

The official MA16 text gives a Department of Labor mailing address. Addresses and billing methods can change, so check the program's current provider instructions before sending.