Healthcare Error Code
Healthcare Insurance / Medical Billing
Common CMS / Medicare Issues

M222 | Authorization issue

Industry
Healthcare
Canonical
/healthcare/error-codes/m222/
Last Updated
Feb 25, 2026
Summary

This code indicates that an authorization-related issue affected claim processing.

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What This Code Means

M222 is used when CMS identifies a problem related to authorization requirements. This may involve missing, invalid, or unmatched authorization records. The code reflects benefit management rules rather than service quality. Coverage eligibility depends on meeting authorization criteria.

Where Users Usually See This Code

  • Medicare remittance advice
  • Authorization review notices
  • EOB explanations

Why This Code Appears

  • Authorization not obtained
  • Authorization details missing or incorrect
  • Authorization expired

What Typically Happens Next

  • Payment is denied or delayed
  • Claim processing completes or pauses
  • Appeal pathways may exist

What This Code Is Not

  • It is not a billing format error
  • It is not patient responsibility
  • It is not a contractual adjustment

Troubleshooting Checklist

  • Review authorization requirements
  • Confirm authorization records
  • Monitor CMS policies

Notes And Edge Cases

Authorization rules vary by program and service. Emergency services may follow different authorization policies.

Related Codes

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