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OA Rejections

Diagnosis code __ not valid for patient age.

Rejection

Diagnosis code specified not valid for patient age.

What happened

Diagnosis code in box 21 is not valid for the patient date of birth in box 3.

Resolution

Verify the patient’s date of birth and review the ICD-10 code’s age restrictions. If necessary, select a diagnosis code appropriate for the patient’s age, update Box 21, and resubmit the claim.