Reason Code: 38200

Error Description:

This claim is an exact duplicate of a previously submitted claim where the following fields on the history and processing claim are the same:

• MBI 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)

Avoiding/Correcting This Error

Always verify the status of a submitted claim before submitting another claim. Verify claim status using the IVR system, FISS/DDE or the NGSConnex online portal. Per CMS mandate, PCC representatives are not permitted to provide claim status over the telephone. You can find the appropriate IVR telephone number on our website under Contact Us.

Even though Medicare payments are generally made 14 days after submission for electronic claims (29 days for paper claims), you should not use this as a guideline for resubmitting a claim.

If you submitted the duplicate claim in error and one of the claims paid, no additional action is required.

If you submitted the duplicate claim in error and both claims rejected, resubmit one of the claims.

If you submitted the duplicate claim to provide additional information for or to change the original claim, then adjust the original claim. If the original claim has not yet finalized, then wait for that claim to finalize (must appear on your remittance) and then submit the adjustment.

Reasons to adjust claims include, but are not limited to:

• Reporting services not previously submitted to Medicare
• Deleting services billed in error Correcting dates of service
• Adding/changing units of service Entering correct diagnosis codes
• Adding primary payer’s payment information (MSP)