Reason Code W7007 - JF Part A

Reason Code Narrative

PROCEDURE AND AGE CONFLICT

Common Reason Code Errors

• One of procedure codes listed in UB04 FL 74 A-E or electronic equivalent is not compatible with birth date of patient listed in UB04 FL 10.
• One of procedure codes listed in UB04 FL 74-A-E or electronic equivalent is not is not compatible with birth date of patient for date of service being billed.

Common Reason Code Corrections

• Verify that procedure codes being billed are valid and compatible with age of patient for date of service. Verify that date of birth is listed correctly. Once corrected, resubmit claim. Providers with Direct Data Entry (DDE) can PF9 claim once corrections are made.

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 25

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