Edit 01129

Part A Deductible Previously Paid For This Spell of Illness

HIPAA Claim Adjustment Reason Code: 18
            Remark Code: N182
HIPAA Healthcare Claim Status Code: 54
            Entity Identifier Code: N/A

Potential Causes:
The Medicare Part A deductible was previously paid for this spell of illness to you or another provider. The previously paid claim was for the full or partial Part A deductible.

Note: An "off line payment" is required if the Admit Date on the claim is within 60 days from the Discharge Date of the earlier claim (counting includes Admit or Discharge date but not both) and the earlier claim is for a partial Part A deductible.

Solution:
Verify the Admit Date is accurate (data location below). If it is correct and a partial Part A deductible is due, documentation must be submitted to the New York State Department of Health at the address below. The documentation must include a letter of explanation and a copy of the page of the remittance showing the denial for edit 1129.

New York State Department of Health
Office of Health Insurance Programs
Division of Medical Review and Provider Enrollment
150 Broadway
Albany, New York 12204

If Medicare applied the full Part A deductible to this claim and the previously paid claim is also for the full Part A deductible, you must contact Medicare and/or the other provider who was paid.