Reason Code W7042

Reason Code Narrative

STANDARD NARRATIVE: MULTIPLE MEDICAL VISITS ON SAME DAY WITH SAME REVENUE CODE WITHOUT CONDITION CODE ‘G0'.

Common Reason Code Errors

  • Multiple medical visits on same day with same revenue code without condition code ‘G0'
  • This code is required to allow payment for OPPS facilities

Common Reason Code Corrections

  • Use ‘G0' condition code when multiple medical visits occur on same day in same revenue center but visits were distinct and constituted independent visits. i.e. 510 or 450 revenue codes
  • Verify coding and ensure there are no duplicate revenue code lines billed
  • If multiple visits occurred on same day, ‘G0' condition code should be present on second claim

Note: Critical Access Hospitals (CAHs) are not allowed to use condition code ‘G0'.

Resources

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

Last Updated May 22, 2018