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.

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.

Explanation:

communicate with the patient and explain every step before proceeding to do so