Expansion of Duplicate Claim Edit

Medicare will modify the duplicate claim edit to reject all clinical laboratory services submitted to payers when it is determined that another payer has already paid for the same service on the same date of service, with the exception of those claims containing the “91” modifier. This modified edit applies to all laboratory claims with dates of service on or after January 1, 2006.

When claims are denied as a result of this edit, Medicare payers will use remark code N347 on the remittance advice to show “Your claim for a referred or purchased service cannot be paid because payment has already been made for this same service to another provider by a payment contractor representing the payer.”