Production Alert Details

FQHC and RHC Claims RTP for W7072

Date Reported:
01/08/2025
Status:
Open
Provider Types Impacted:

FQHCs and RHCs

Reason Code(s):
W7072
Claim Coding Impact:
HCPCS code 93010

Description of Issue

Between 10/1/2024 and 12/31/2024, RHC (TOB 071X) and FQHC (TOB 077X) claims that contained HCPCS code 93010 were RTP in error with reason code W7072.

National Government Services Action

We will reprocess impacted claims that are resubmitted (PF9) by providers and will bypass this error until the April 2025 IOCE release has been installed.

Provider Action

Resubmit (PF9) 071X and 077X claims which received reason code W7072 between 10/1/2024 and 12/31/2024.

Proposed Resolution/Fix

The April 2025 IOCE release should correct this issue.