Reason Code 7THER
Reason Code Narrative
THERAPY CAP - PROVIDER LIABLE
Common Reason Code Errors
Therapy services billed exceed the pre-determined therapy cap.
Common Reason Code Corrections
- If therapy service is justifiable a Redetermination request should be submitted. Request should include:
- All applicable supporting medical documentation
- Corrected UB-04 form
- If excessive units were submitted in error, a Redetermination can be submitted.
Redeterminations will only review medically denied lines.
View reason code list, return to Reason Code Guidance page.
Last Updated May 22, 2018