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'.
- CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 4, Section 180.4
- CMS Change Request (CR)5425 (Appendix B)
View reason code list, return to Reason Code Guidance page.
Last Updated May 22, 2018