Reason Code W7070 - JE Part A

Reason Code Narrative

CA MODIFIER REQUIRES PATIENT STATUS CODE 20.

Common Reason Code Errors

• Modifier CA has been listed on claim and patient status 20 (expired) is not present

Common Reason Code Corrections

• Verify codes billed are correct for procedures billed. If modifier CA is appropriate, then patient status in FL 17 must be reflected as 20

Resources

• CMS Definitions of Medicare Code Edits
• CMS Integrated Outpatient Code Editor (IOCE)
• CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual Chapter 4, Section 180.7

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