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

M59 | Incomplete claim

Industry
Healthcare
Canonical
/healthcare/error-codes/m59/
Last Updated
Feb 25, 2026
Summary

This code indicates that the Medicare claim was incomplete and could not be fully processed.

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What This Code Means

M59 is applied when required claim components are missing or incomplete. CMS cannot adjudicate incomplete claims. This is an administrative issue rather than a coverage decision. Once the missing elements are addressed, the claim may be eligible for reprocessing.

Where Users Usually See This Code

  • Medicare remittance advice
  • Claim rejection notices
  • CMS claim processing reports

Why This Code Appears

  • Missing claim data elements
  • Incomplete service or provider details
  • Submission errors

What Typically Happens Next

  • Claim processing stops
  • Reprocessing may be required
  • Payment is delayed

What This Code Is Not

  • It is not a non-covered service
  • It is not patient responsibility
  • It is not a contractual adjustment

Troubleshooting Checklist

  • Review claim completeness
  • Verify required data fields
  • Monitor resubmission guidelines

Notes And Edge Cases

Incomplete claims are common during system transitions. CMS-specific rules affect completeness criteria.

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