Reason Code W7020 - JE Part A

Reason Code Narrative

CODE 2 OF A CODE PAIR THAT IS NOT ALLOWED BY NCCI EVEN IF APPROPRIATE MODIFIER IS PRESENT.

Common Reason Code Errors

• HCPC or CPT pair being billed is not allowed even with an appropriate modifier when it is billed on same date of service as a code pair

Common Reason Code Corrections

• Verify HCPC or CPT pair billed is valid

Resources

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

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