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OA Rejections

Diagnosis code __ not valid for patient gender

Rejection

Diagnosis code (letter/number will be specified) not valid for patient gender

What happened

Diagnosis code specified in box 21 is not valid for the patient gender selected in box 3.

Resolution

Verify the patient’s gender and check the ICD-10 code’s gender-specific requirements. If needed, update Box 21 with a diagnosis code valid for the patient’s gender and resubmit the claim.