Reason Code 34072

Reason Code Narrative

CLAIM SUBMITTED AS MEDICARE PRIMARY AND A POSITIVE WORKING ELDERLY RECORD EXISTS AT CWF. HOWEVER, AN OCCURRENCE CODE '18' IS PRESENT ON THE CLAIM.

Common Reason Code Errors

  • A claim is billed for Medicare primary payment; however, there is a valid Working Aged file listed on Common Working File (CWF) and claim contains an occurrence code 18

Common Reason Code Corrections

  • If beneficiary is retired, contact Benefits Coordination and Recovery Center (BCRC) to update Working Aged file
  • If beneficiary is retired resubmit claim including detailed remarks verifying beneficiary's retirement date
  • If beneficiary is not retired and an 18 occurrence code is present on claim, verify if 18 occurrence code is correctly used

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

Last Updated Oct 19, 2018