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Issue Number - Name
0064 - Facility Duplicate Claims
Review Type
Automated
Claim Type
Hospital Facility, Skilled Nursing Facility (SNF), Clinics, Outpatient Rehabilitation Facility (ORF), Comprehensive Outpatient Rehabilitation Facility (CORF)
Region and State
RAC 1-4
All States
Date Approved
2017-09-06

Description

Duplicate claim or line date of service items are those where the same service is rendered and paid multiple times on the same date of service for the same beneficiary.

Affected Code(s)

  • No specific codes

Applicable Policy References

  • Title XVIII of the Social Security Act, Section 1833(e)
  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 1
  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 120.2 (A)
  • CMS Pub. 100-06, Medicare Financial Management Manual, Chapter 3, Section 10.2