Reason Code: W7010
Error Description:
The provider determined that the billed services are noncovered or excluded; thus, this claim was submitted with condition code 21 to obtain a Medicare denial. The services on this “no-pay” claim may now be submitted to another insurer.
Avoiding/Correcting This Error
Condition Code 21 is appropriate to use to submit on a “no pay” claim when seeking a denial from Medicare to facilitate payment by subsequent insurers. This denial allows the subsequent insurer to consider payment of the services.
Related Content
- CMS Internet-Only Manual 100-04, Medicare Claims Processing Manual, Chapter 1, Section 60.1.3 - Claims with Condition Code 21