Reason Code W7066

Reason Code Narrative

CODE REQUIRES MANUAL PRICING.

Common Reason Code Errors

  • Unclassified drug or biological HCPC code requires manual pricing and claim is missing drug name and dosage in comments field of claim

Common Reason Code Corrections

  • Include drug name and dosage given on Direct Data Entry (DDE) claims page four, FL 80, or electronic equivalent
  • Information will be reviewed and verified by Noridian staff and either allowed or denied pending medical necessity

Note: If HCPC code C9399 is used, include the National Drug Code (NDC), the quantity of the drug that was administered, expressed in the unit of measure applicable to the drug or biological, and the date the drug was furnished to the beneficiary. The NDC number, quantity and qualifier are entered in DDE screen 2C. Screen 2C is accessed by going to DDE page 2, and pressing PF11 once.

Resource

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

 

Last Updated Fri, 28 Feb 2020 12:40:01 +0000