RARC M80
Not covered on the same date as another service
The service is not payable when performed on the same day or session as something already processed.
Why you actually get this
- A same-day combination the payer does not allow.
- A genuinely distinct encounter billed without a modifier separating it.
How to check whether it’s correct
- 01Establish whether the two services were separate encounters.
- 02Check whether a modifier applies.
Sometimes worth appealing
Where the encounters were genuinely separate — a morning visit and an unrelated afternoon procedure — documentation and a modifier usually recover it.
Often arrives with
Seeing a lot of these?
A single denial is a claim to work. A pattern of the same denial is a process to fix, and the two need completely different responses. A free panel reads ninety days of your claims data and shows which codes actually recur for you.
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