Reason Code W7099

Published 12/16/2019

Claim with pass-through or non-pass-through drug or biological lacks OPPS payable procedure.

Claims receiving this reason code in error were suspended until the January 2017 Integrated Outpatient Code Editor (IOCE) was implemented.

If there are claims that are RTP'd in error, F9 and resubmit, and claims will be suspended until the correction is implemented.

Note: There was an additional issue with W7099 editing incorrectly on non-OPPS claims. CMS and FISS have provided a work around for this issue. If you have claims RTP'd in error, F9 those claims for the work around to be applied.

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