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

M251 | Billing discrepancy

Industry
Healthcare
Canonical
/healthcare/error-codes/m251/
Last Updated
Feb 25, 2026
Summary

This code indicates that a discrepancy was identified in billing information.

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What This Code Means

M251 is applied when CMS detects inconsistencies or discrepancies in billed amounts or details. This is an administrative billing validation issue. It does not independently determine coverage. Corrected billing information may allow reprocessing.

Where Users Usually See This Code

  • Medicare remittance advice
  • Claim adjustment notices
  • Billing reconciliation reports

Why This Code Appears

  • Inconsistent billing amounts
  • Data mismatches within the claim
  • CMS billing rules enforced

What Typically Happens Next

  • Claim is adjusted or denied
  • Reprocessing may be required
  • Payment is delayed

What This Code Is Not

  • It is not a coverage exclusion
  • It is not patient responsibility
  • It is not a contractual adjustment

Troubleshooting Checklist

  • Review billing details
  • Confirm data consistency
  • Monitor adjustment notices

Notes And Edge Cases

Discrepancies may arise from system rounding or data mapping issues. Automated edits frequently identify these issues.

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