Edit 00705

Service Paid Current or Previously Conflicting Claim

HIPAA Claim Adjustment Reason Code: 18
     Remark Code: N/A
HIPAA Healthcare Claim Status Code: 54
     Entity Identifier Code: N/A

Potential Causes:
The claim was previously paid to this provider or group for this patient and this date of service, causing the claim to deny.

Solution:
Please review your current and past remittance statements. Even if a claim paid at a zero dollar amount, it is still considered paid (the most common cause of this is the payment being applied to Spenddown)..

• If the claim paid zero, a replacement (adjustment) claim may be necessary to correct your payment. 

Please Note: If you receive paper remits, the paid TCN is directly under the denied TCN.  You may look at the paid date to determine in which cycle the claim was paid.