Reason Code 38200 - JE Part A

Reason Code Narrative

THIS CLAIM IS AN EXACT DUPLICATE OF A PREVIOUSLY SUBMITTED CLAIM WHERE THE FOLLOWING FIELDS ON THE HISTORY AND PROCESSING CLAIM ARE THE SAME;

• HIC NUMBER
• TYPE OF BILL (ALL THREE POSITIONS OF ANY TOB)
• PROVIDER NUMBER
• STATEMENT FROM DATE OF SERVICE
• STATEMENT THROUGH DATE OF SERVICE
• TOTAL CHARGES (0001 REVENUE LINE)
• REVENUE CODE
• HCPCS AND MODIFIERS (IF REQUIRED BY REVENUE CODE FILE)

Common Reason Code Errors

• Claim submitted is exact duplicate of previously submitted claim and fields listed above are same on history and processing claim.

Common Reason Code Corrections

• Verify and review services submitted against claims history.
• If additional charges must be included on prior claim, submit an adjustment.
• Do not submit a new claim.

Resources

• CMS Internet Only Manual (IOM) Publication 100-04, Chapter 4, Section 180.4
• CMS IOM, Publication 100-04, Chapter 16, Section 100.5
• CMS Change Request (CR) 4047

View reason code list, return to Reason Code Guidance page.