What are occurrence codes?
Asked by: Dr. Jed Sporer DDS | Last update: July 16, 2025Score: 4.9/5 (37 votes)
What are occurrence codes on a UB04?
A code to describe to describe specific event(s) relating to this billing period covered by the claim. These codes are associated with specific date(s); refer to the occurrence code start (OCRNC_CD_START_DT) and end dates (OCRNC_CD_END_DT). 01. Auto accident Code indicates the date of an auto accident. This code is used to report an auto accident that involves liability insurance. Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) will use occurrence code 50 to report the date on which assessment data was transmitted to the CMS National Assessment Collection Database. Occurrence code 50 must be reported on all IRF PPS (11x bill types)What is the purpose of occurrence code?
What does occurrence code 01 mean?
What does occurrence code 50 mean?
What are Revenue Codes in Medical Billing?
What is occurrence code 70?
OCCURRENCE SPAN CODES. 70 Qualifying Stay Dates (SNF)/Non-Utilization Dates: Dates represent at least a three-day hospital stay that qualifies the client for Medicare payment of SNF services billed.
What is a 32 occurrence code?
Occurrence code 32 on a claim signifies that an ABN, Form R-131, was given to a beneficiary on a specific date. This code must be employed if this specific ABN form is given, and condition code 20 will not be used on the subsequent claim (i.e., no charges will be submitted as non-covered).
What is the occurrence code 40?
Occurrence Code 40 (Scheduled Date of Admission): This code and corresponding date indicate when the patient will be admitted to the hospital as an inpatient. This code is valid only on an outpatient claim and must be used in conjunction with occurrence code 41 (Date of First Test for Preadmission Testing).
What is occurrence code 10?
A code to describe specific event(s) relating to this billing period covered by the claim. (These are From Locators 31, 32, 33, 34, 35, and 36 - Occurrence Codes on the UB04.) These fields can be used for either occurrences or occurrence spans.
What is occurrence code 52?
Condition codes. Condition code 52 is required to report a discharge due to the patient's unavailability/inability to receive hospice services from the hospice which has been responsible for the patient.
What is the status code 40?
Status Code 40: The connection between the client and the server was broken.
What is occurrence code 47?
Occurrence code 47 -- indicates the first day the inpatient cost outlier threshold is reached or the date after the DRG cutoff date.
What is occurrence in coding?
Code Occurrence - It is evaluated how many documents contain two codes. The position of the two codes is irrelevant; they must both have been assigned at least once in the document.
What is condition code 01?
Understanding the Conditions/Situations Mentioned by NUBC
The NUBC's 2007 manual lists 99 situations with numeric codes ranging from 01-99. For example, sub-code 01 refers to the Military Service-Related situation explained as medical conditions incurred during military service.
What does an occurrence code represent?
Occurrence span codes are displayed on Institutional claims to identify a specific event related to a claim, which occurred for a certain span of time.
What is occurrence code 61?
Occurrence code 61 – “Hospital Discharge Date” is reported, but not required, on final admission claims and continuing claims, if applicable.
What does occurrence code 45 mean?
Common causes of code 45 are: 1. Charge exceeds fee schedule: This code is often triggered when the healthcare provider's charge for a particular service or procedure exceeds the fee schedule set by the payer. It indicates that the provider has billed an amount higher than what is allowed or agreed upon. 2.
What is occurrence code 48?
Occurrence Codes
23 - Date of Cancellation of Hospice Election period. 48 - Date hospice face-to-face encounter was untimely 49 – Not currently used by Medicare.
What is occurrence code 51?
• Occurrence code 51: Date of last Kt/V reading. For in-center hemodialysis patients, this is the date of. the last reading taken during the billing period.
What is occurrence code 44?
Condition code 44 is used when an inpatient admission is being changed to outpatient. According to the CMS IOM Pub. 100-04, Medicare Claims Processing Manual, Chapter 1 -- General Billing Requirements.
What is occurrence code 32?
There are three situations that require issuance of the ABN to a hospice patient: The beneficiary is not "terminally ill"; The items or services that are billed separately from the hospice payment, such as physician services, are not reasonable and necessary; or.
What is occurrence code 72?
Occurrence Span Code 72; Identification of Outpatient Time Associated with an Inpatient Hospital Admission and Inpatient Claim for Payment. hospital care.
What is occurrence code 54?
CR 9474 informs you of revisions of the Medicare billing instructions for home health claims to allow the use of a new condition code - 54. The code indicates that the HHA provided no skilled services during the billing period, but the HHA has documentation on file of an allowable circumstance.