Reason Code W7002 - JE Part A

Reason Code Narrative

THE DIAGNOSIS BILLED AND THE BENEFICIARY'S AGE ARE CONFLICTING.

Common Reason Code Errors

• One of diagnosis codes listed in UB04 FL 66–69, or electronic equivalent, is not compatible with age of patient listed in UB04 FL 10
• One of diagnosis codes listed in UB04 FL 66–69, or electronic equivalent, is not compatible with age of patient for date of service being billed

Common Reason Code Corrections

• Verify that diagnosis codes being billed are valid and compatible with age of patient for date of service. Verify that date of birth is listed correctly. Once corrected, resubmit claim. Providers with Direct Data Entry (DDE) can PF9 claim once corrections are made.

Resources

• CMS Definitions of Medicare Code Edits
• CMS Integrated Outpatient Code Editor (IOCE)

View reason code list, return to Reason Code Guidance page.