Exact Duplicate Claim/Service - JF Part B
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Exact Duplicate Claim/Service
CARC/RARC | Description |
---|---|
OA-18 | Exact duplicate claim/service |
N522 | Duplicate of a claim processed, or to be processed, as a crossover claim. |
Common Reason for Message
- This is a duplicate to a service that has already been paid.
Next Steps
- Verify medical documentation for the following:
- Service appropriate to bill
- Date of service
- Is a modifier required?
- Payment already allowed and/or paid to patient's deductible
- Submit Appeal request - Items or services with this message have appeal rights
- Indicate services were not duplicate
- Submit documentation with Redetermination request. View Medical Documentation Requirements
Claim Submission Tips
- When billing repeat procedures, append most appropriate repeat modifier to procedure code
- Modifier 76 - Repeat procedure by same physician
- Modifier 91 - Repeat clinical diagnostic lab test
- Modifier JW - Drug amount discarded/not administered to any patient
- When possible include all line items on a single claim
- Allow 30 days from first claim submission before resubmitting or after remittance received
- Check claim status via Noridian Medicare Portal or the Interactive Voice Response (IVR)
Last Updated Tue, 20 Oct 2020 17:27:26 +0000