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Reason Code: 38031

Error Description:

This outpatient claim is possibly a duplicate to a previously submitted claim and the following conditions exist:

  • From/Thru dates overlap
  • Provider numbers are the same
  • At least one revenue code is the same
  • Duplicate diagnosis codes on both claims
  • HCPC matches but different revenue codes
  • Duplicate modifiers

Avoiding/Correcting This Error

If appropriate, correct and resubmit a new claim.

To prevent this error on future claims, ensure you have received all charges from all departments and that no claim has been submitted for the same DOS and beneficiary prior to submitting a claim.  Utilize the IVR system, NGSConnex or FISS to determine whether a claim has already been submitted for this date of service.

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