Reason Code W7019 - JE Part A

Reason Code Narrative

MUTUALLY EXCLUSIVE PROCEDURE THAT IS NOT ALLOWED, EVEN IF APPROPRIATE MODIFIER IS PRESENT.

Common Reason Code Errors

• HCPC or CPT billed is not allowed even with an appropriate modifier when it is billed on same date of service as mutually exclusive codes

Common Reason Code Corrections

• Verify HCPC or CPT combination being billed is correct

Resources

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

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