Last Modified: 12/7/2009
Location: FL, PR, USVI
Business: Part B
(DUPLICATE CHARGE PAID ?002XX ON CLAIM ?001XXXXXXXXX)
(DUPLICATE CHARGE OF CLAIM ?001XXXXXXXXX NOW BEING PROCESSED)
(THIS IS A DUPLICATE OF A CHARGE WE HAVE PROCESSED)
(MORE THAN 1 E/M SERVICE BILLED ON THE SAME DAY)
Resources/tips for avoiding this denial
• Do not resubmit an entire claim when partial payment made; when appropriate, resubmit denied lines only.
• Click here to view frequently-asked questions (FAQs) regarding duplicate claims.
Regarding evaluation and management (E/M) services, physicians in the same group practice of the same specialty must bill and be paid as though they were a single physician.
• Only one E/M service may be reported per patient, per day by a physician or by more than one physician of the same specialty in the same group, unless the evaluation and management services are for unrelated problems.
• If more than one face-to-face E/M is provided on the same day to the same patient by the same physician or by more than one physician of the same specialty in the same group, instead of billing separately, the physicians should select a level of service representative of the combined visits and submit the appropriate code for that level.
• Physicians in the same group practice but who are in different specialties (e.g., a cardiologist and a general practice physician) may bill and be paid without regard to their membership in the same group.
• Free Web-based training (WBT) Duplicate claims -- Part B
• Recording of a FCSO webcast on January 21, 2009:
Understanding and resolving duplicate claim denials -- Part B, located in the "Library" of the
FCSO Medicare training Web site 
, and may be accessed under "Online resources."
Tips to correct the denied claim
If submitting a claim to correct an error, be sure to submit only the corrected line. Resubmitting an entire claim will cause a duplicate claim denial.
• Ensure necessary appropriate modifiers are appended to claim lines.
• Refer to the
Modifier FAQs here on the FCSO Medicare provider Web site for additional information.
Please use your browser's
back button to return to the referring page.
Source: FCSO Education Action Team
for additional details.
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