38200

FISS 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:
  • Beneficiary's Medicare ID 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)

This reason code cannot be overridden, bypassed or turned off. 

Explanation and Suggestion
This is one of several reason codes that indicates that a duplicate claim has been received in the Medicare claims system or FISS. We encourage you to track submitted claims.

Reason code 38200 indicates an exact duplicate of a previously submitted processed claim.

Paid claims may only be canceled or adjusted. Claims denied by Medical Review may only be appealed.

Two job aids are available to assist you in determining whether a claim should be adjusted, canceled or appealed. The job aids are located on the Palmetto GBA website under Top Links. 

Be sure to notify software vendors if necessary.

Contact Palmetto GBA JM Part HHH Medicare

Email HHH

Contact a specific JM HHH department

Provider Contact Center: 855-696-0705

TDD: 866-830-3188

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