Same Procedure Code


How to submit a claim when two identical procedures have been conducted

I submitted this for manual review because I had to do 2 arterial repairs but it looks like the Ministry rejected one procedure. Would this be based on the manual review? Next step is RA form?


When two identical procedures have been conducted, the service code should be submitted with a quantity of 2. Submitting duplicate entries will cause rejection because the MoH assume it is a mistake. To correct this, you will need to submit an RA inquiry to change the quantity of the service code to two (2). 

Please let me know if you have further questions.
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