M86M-series (Medicare line-level)Coding & Bundling
M86: Same/similar service paid within timeframe
Payment was already made for the same or a similar service within the payer's frequency window (e.g., DME replacement schedules, screening intervals).
Commonly appears with these denial codes
The denial code gives the category; M86 pinpoints the specific problem. Read them together before touching the claim.
What to do about it
Verify the patient's service history. If circumstances changed (lost equipment, new diagnosis, medical necessity), appeal with documentation; otherwise the frequency limit stands.
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