Duplicate Claim/Service

CARC/RARC Description
CO-97 The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
CO-B20 Procedure/service was partially or fully furnished by another provider.
N111 No appeal right except duplicate claim/service issue. This service was included in a claim that has been previously billed and adjudicated.

 

Common Reason for Message

  • This is a duplicate of a charge already submitted

Next Step

  • Verify documentation for the following:
    • Service is appropriate to bill
    • Is a modifier is required
    • Payment was already allowed and/or paid to patient's deductible
  • Submit an Appeal request - Items or services with this message have appeal rights

Claim Submission Tips

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

 

Last Updated Nov 13, 2017