- Avoiding Reason Code 38200
- Correcting Reason Code 37253
- Reason Code 39929
- Influenza and Pneumonia Vaccinations in the Home Health and/or Hospice Setting
- Certification or Recertification of Medicare Covered Home Health Services
- Billing the Home Health Period of Care Claim - PDGM
- Disposable Negative Pressure Wound Therapy Services Under Home Health
- MLN Matters® 11855 Request for Anticipated Payment Submission Frequently Asked Questions
- Home Health Prospective Payment System Booklet
- Home Health Third Party Liability Demand Billing
- Home Health Demand Billing
- Counting 60-Day Episodes
- Notice of Admission Questions and Answers
- Home Health Patient-Driven Groupings Model (PDGM) FAQs
- Billing the Home Health Notice of Admission Electronically
- Billing the Home Health Notice of Admission via DDE
- Home Health Requests for Anticipated Payment
- Home Health Transfers
- Home Health Agency Transfer and Dispute Protocol
- Late Notice of Admission - The Exception Process
- Reporting Home Health Episodes with No Skilled Visits
- Telehealth Home Health Services: New G-Codes
- Reporting Site of Service Codes for Home Health Care
- PDGM Resources
- Billing G-Codes for Therapy and Skilled Nursing Services
- Correcting and Avoiding Reason Code 38157: Duplicate Request for Anticipated Payment
- Correcting and Avoiding Reason Code C7080: Inpatient Overlap
- Completing the Advance Beneficiary Notice for Home Health Agency Demand Claims
- Correcting and Avoiding Reason Code C7010: Overlap With a Hospice Election Period
- The Medicare Home Infusion Therapy Benefit and Home Health Agencies
- Home Health Therapy Billing
- Home Health Billing When a New MBI is Assigned
- Correcting and Avoiding Overlap Reason Codes
- 30-Day Home Health Therapy Reassessment Schedule
Avoiding Reason Code 38200
Claims are rejected with reason code 38200 when the FISS finds a previously submitted billing transaction that is a duplicate of the recently submitted billing transaction where all of the following fields on the history and processing claim are the same:
- MBI number
- TOB (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)
Although duplicate claim submissions will occur from time to time intentionally or unintentionally, filing duplicate claims, even if it does not result in duplicate payment, could directly or indirectly result in unnecessary costs to the Medicare Program.
How to Avoid This Reason Code
All additions and/or corrections to processed claims need to be sent on an adjustment/late charge claim. In very limited situations such as MSP rejections, the rejection claim also needs to be adjusted. Also, check the FISS/DDE Provider Online System and/or the remittance statement for the previous claim before resubmitting it.