Billing > Billing

Duplicate diagnosis codes

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muraiken:
I am working for a health plan so am looking at things from the payor side and I do see claims coming in with duplicate diagnosis codes.
My question is if Medicare has some specific rule that it will reject claims with duplicate diagnosis codes......

DMK:
I have accidentally input the same dx twice on a Medicare claim and it was not rejected.  I felt stupid though! 

PMRNC:

--- Quote ---I am working for a health plan so am looking at things from the payor side and I do see claims coming in with duplicate diagnosis codes.
My question is if Medicare has some specific rule that it will reject claims with duplicate diagnosis codes......
--- End quote ---

That really wouldn't matter because every insurer has a diff payor program, I worked at 3 of the top 5 and we always had these edits in place to flag duplicate info of any kind on a claim form. It also depends on the procedure for that flag.. with billing you mostly have to go by Medicare guidelines for clean claims. 


--- Quote ---I have accidentally input the same dx twice on a Medicare claim and it was not rejected.  I felt stupid though! 
--- End quote ---

I would THINK you should have this edit on clearinghouse side if it's not in your PM setup

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