Reason Code 7R176 - JE Part A
Reason Code 7R176
Reason Code Narrative
Documentation does not support the medical necessity of the service billed.
Common Reason Code Errors
- Documentation does not support medical necessity of service
Common Reason Code Corrections
- Review your Recovery Audit Contractor (RAC) findings letter compared with the documents submitted to the RAC for review.
- A Redetermination may be submitted if provider feels that sending in additional documentation will support need for service(s). The redetermination should include:
- All applicable supporting medical documentation
- Corrected UB-04 claim form
- Review National Coverage Determination (NCD) and the Local Coverage Determination (LCD) as applicable.
- Direct Data Entry (DDE) users can view remarks section for additional clarification.
Last Updated Tue, 12 Jul 2022 18:54:54 +0000