Question

Based on your understanding of the scenario, why was the claim rejected? The claim was submitted for the wrong patient. ICD-10-CM codes are used to code claims for hospital care. HCPCS codes are used to code claims for hospital care. The incorrect diagnosis was stated on the claim form.

Answer 1

The payer rejected this claim because the Health Care Diagnosis Code (ICD-10) is not valid. There are a few known causes for this rejection: The Diagnosis Code is not valid for any service factor including Date of Service, Age, CPT code, etc. You used an incorrect Diagnosis Code for the Service.

Step-by-step explanation: