Revisions to the Competitive Acquisition Program (CAP) for Part B Drugs and Biologicals
Due to a systems edit, CAP claims with the same date of service for the same HCPCS drug code for the same beneficiary are denying as duplicate claims though the prescription order number on the claims are different. The same action may be occurring when lines on the same claim appear to be duplicates except for different prescription order numbers. For claims processed on or after January 5, 2009, this Change Request will revise systems and contractor coding to allow these claims to not be considered duplicate claims when the prescription order number is different.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: August 15, 2008
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