Skip to main content

N522 Remark Code: Duplicate of a Crossover Claim

N522 means the claim duplicates one that has been processed, or will be processed, as a crossover claim. The primary payer, often Medicare, forwards the claim to the secondary payer automatically, so the direct submission was denied.

Quick facts

Code
N522 (RARC N522)
Status
Active In use since November 1, 2009; last modified March 1, 2010.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • OA (Other Adjustment): Duplicate denials are commonly reported as other adjustments. The crossover claim, not this one, carries the payment decision.
  • CO (Contractual Obligation): Some payers report the duplicate under CO. It is still not billable to the patient.
Official description
Duplicate of a claim processed, or to be processed, as a crossover claim.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N522 means

Crossover is an automated handoff. After a primary payer, most commonly Medicare, adjudicates a claim, it forwards the claim and payment data to the patient’s secondary coverage, such as a Medigap plan or Medicaid. The secondary payer processes that forwarded claim without the provider sending anything.

If the provider also submits the same services directly to the secondary payer, the secondary sees two claims. N522 is its way of saying: we are using the crossover version, and this direct one is a duplicate.

Common causes

  • Staff billed the secondary as soon as the primary paid, without checking the crossover remark.
  • The billing system automatically generates secondary claims for all patients, including those with crossover arrangements.
  • The secondary claim was sent before the crossover arrived, and both reached the payer.

What to do

  1. Do not resubmit. Check the primary remittance for a crossover remark.
  2. Wait for the secondary payer to process the crossover claim and post its payment when it arrives.
  3. Follow up if the secondary payment has not arrived after a reasonable period. Confirm with the secondary whether it received the crossover.
  4. Submit directly only if the secondary confirms it never received the crossover and tells you to.

How to prevent it

Configure your system to suppress automatic secondary claims when the primary remittance shows the claim was crossed over. The duplicate claims guide covers other ways to avoid duplicate submissions.

Codes that may appear with N522

  • OA-18 (Exact duplicate claim/service (Use only with Group Code OA except where state workers' compensation regulations requires CO)): Exact duplicate claim or service; N522 explains that the original is the crossover claim.
  • OA-23 (The impact of prior payer(s) adjudication including payments and/or adjustments. (Use only with Group Code OA)): The prior payer's adjudication affects the secondary payment on the crossover claim.
  • MA18 (Alert: The claim information is also being forwarded to the patient's supplemental insurer.): Medicare's alert that the claim was forwarded to the supplemental insurer.
  • N89 (Alert: Payment information for this claim has been forwarded to more than one other payer, but format limitations permit only one of the secondary…): Payment information was forwarded to more than one other payer.
  • MA68 (Alert: We did not crossover this claim because the secondary insurance information on the claim was incomplete.): Medicare did not cross over the claim because secondary insurance information was incomplete.
  • N8 (Crossover claim denied by previous payer and complete claim data not forwarded.): The crossover claim was denied by the previous payer and complete data was not forwarded.

N522 FAQ

How do I know a claim crossed over?

Look at the primary payer's remittance. Medicare, for example, uses remarks such as MA18 or N89 to show the claim was forwarded to another payer.

What if the crossover never arrives?

Allow the secondary payer's normal processing time, then check its portal or call. If it has no record of the crossover claim, ask how to submit directly.

Should I appeal N522?

Usually not. Wait for the crossover claim to process. Appeal only if you confirm the crossover did not occur and the payer still refuses a direct claim.