Skip to Main Content

Print | Bookmark | Email | Font Size: + |

Reason Code Search and Resolution

Disclaimer: This is not a complete list of reason codes.

The Reason Code Search and Resolution tool allows you to view a reason code description and determine how to prevent/resolve the edit. You may search by reason code or keyword. All records matching your search criteria will be returned for your review. You may also select "Show all Reason Codes" to view the complete list.

If the reason code you enter does not display here, you may access any reason code description in the Fiscal Intermediary Standard System (FISS) Direct Data Entry (DDE) Reason Codes Inquiry Menu (Option 17) . For additional information, please reference the FISS DDE User Manual.

Search by:

Reason Code W7C01

Description:

The third diagnosis code listed on the claim is invalid.

Resolution:

  • Before submitting your claim, review the ICD-10 codes to ensure they are valid.
  • ICD-10 resources include:
  • Remember, updates to the ICD-10 codes are effective October 1st of each year
  • Access the claim in the Return to Provider (RTP) file. Refer to the Return to Provider (RTP) Web page for additional information.
  • Make the correction to the claim by replacing the invalid diagnosis code with a valid diagnosis code and press F9 to allow the claim to continue processing.

Updated: 06.29.21

Disclaimer: CGS' online tools and calculators are informational and educational tools only, designed to assist suppliers and providers in submitting claims correctly. CGS makes no guarantee that this resource will result in Medicare reimbursement for services provided. Although we've made every reasonable effort to provide effective resources, CGS is not responsible for the consequences of any decisions or actions taken in reliance upon or as a result of the information that these tools provide. CGS is not responsible for any human or mechanical errors or omissions.

spacer

26 Century Blvd Ste ST610, Nashville, TN 37214-3685 © CGS Administrators, LLC. All Rights Reserved