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What can I do if I receive Remittance Advice Details (RAD) code 095: Service is not payable due to a procedure/modifier previously reimbursed?

April 26, 2017advice code modifier Payable procedure RAD remittance service

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What can I do if I receive Remittance Advice Details (RAD) code 095: Service is not payable due to a procedure/modifier previously reimbursed?

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Call the Telephone Service Center (TSC) at 1-800-541-5555. If the provider’s record indicates non-payment, an appeal needs to be filed. For more information on appeals, Long Term Care, Pharmacy and Vision Care providers should refer to provider manual Section 400-61. Allied Health, Inpatient, Outpatient and Medical Services providers should refer to Appeal Process Overview in the Part 1 manual.