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Reason Code Search and Resolution

Disclaimer: This is not a complete listing of reason codes. Other reason codes will be added.

This Reason Code Search and Resolution tool has been designed to aid Medicare providers in reviewing reason codes and how to resolve the edit or use them for determining if other action is needed. You may search this database by reason code or keyword. All records matching your search criteria will be returned for your review. If you are aware of a reason code not listed or a description and/or a resolution is not clear, please send your suggestion for reason code addition or update to J15_PARTA_Education@cgsadmin.com.

If you wish, you may also view the entire listing of reason codes, their descriptions, resolutions, and additional billing information by clicking on the "Show all Reason Codes" option.

Reason Code 38200

Description:

This claim is an exact duplicate of a previously submitted claim.

Resolution:

  • Verify the information submitted on the claim.
  • If you need to correct information on the previously submitted claim, submit an adjustment claim.

Reason Code 38200

Description:

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

  • MBI
  • Type of Bill (All three positions)
  • Provider Number
  • Statement from and through date of service
  • Total Charges (0001 Revenue Line)
  • Revenue Code(s)
  • HCPCS and Modifiers (if required by revenue code file)

Resolution:

Ensure the previously submitted claim has finalized. If information from previously submitted claim needs to be corrected, submit an adjustment claim.

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