Medicare & Veteran Affairs: Adjustments for duplicate claims
CMS entered into an agreement to identify claims paid by both Medicare and the Department of Veteran Affairs (VA). Starting July 2025, First Coast will take action to recover any duplicate payments.
Duplicate recovery requests will occur over a “phased in” period and will not happen all at once. Physicians, providers, and other suppliers will receive claims recoveries or adjustments for dates of service starting June 6, 2019, to the present.
The following information will identify the overpayment in your remittance advice:
- Claim Adjustment Reason Code 16 - Claim / service lacks information or has submission / billing error(s)
- Group Code CO - Contractual obligation
- Remittance Advice Remark Code (RARC) M79 - Missing / incomplete / invalid charge
- RARC MA67 - Alert: Correction to a prior claim
Reference