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TM4 -Telemedicine error code

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Background:

This rejection may occur if the claim is for telemedicine, and a non-telemedicine claim for an eligible telemedicine service was paid to the same physician, same patient, same service date.

Solution:

If the previous claim was wrong, and should have included telemedicine, then you will need to submit an RA Inquiry to correct the code.

If the non-telemedicine claim and telemedicine billing is correct because both services were rendered the same day in both telemedicine and non-telemedicine settings, then the rejected billing should be resubmitted with Manual Review, and a written explanation should be sent in to your claim assessor.

 

 

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