Eclipse has a limitation of 14 items per 'voucher'. AA automatically puts additional items into a second voucher. Rejections can occur because Medicare processes each voucher separately. If a voucher contains items that are part of an RVG anaesthesia service, but they don't contain the RVG base and time items, they can be rejected. Medicare does not have a fix for this at present. This is a particular problem if the 15th item on the account is the after hours modifier. This is likely to be rejected because it is not associated with an anaesthetic procedure (even though the anaesthetic procedure is described in the preceding 14 items).

 

AA will warn you if you have more than 14 items, and will give you the option to continue with the claim, or to quit and adjust the account. It is advisable in these circumstances to send the claim manually.

 

A similar problem can occur with ICU accounts where multiple items are included over a number of days. We have had instances where blood pressure monitoring items are split across two vouchers, so that one pressure is the 14th item (1st voucher) and another pressure is the 15th item (2nd voucher). Even though the items are specified for different pressures, Medicare is inclined to reject the second item with the reason 'duplicate service'. In such case, we suggest reordering the items so that the similar numbers are not separated at item 14, or to create separate accounts, possibly divided by the date of service.