W0452

FISS Narrative:
The first diagnosis code is invalid. Please refer to the latest ICD-10-CM coding book to validate the code. Be sure that the statement covered dates fall within the effective date for the ICD-10-CM code you are using.

Explanation and Suggestion:

  • This reason code indicates that the first/primary diagnosis code (the code on your screen at #1 among the diagnosis codes on claim page 3) for the date of service billed does not match a valid code on the FISS ICD-10-CM code file (menu option #15)
  • Check this code against the file and correct it accordingly
  • Please correct and resubmit/rekey
  • Hard copy submitters resubmit RTP report with corrections

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