What are the occurrence codes?
Asked by: Prof. Simeon Bayer I | Last update: December 6, 2023Score: 5/5 (63 votes)
Occurrence Codes identify a significant event relating to an institutional claim that may affect payer processing. These codes are claim-related occurrences that are related to a time period (span of dates).
What is the occurrence code on a claim?
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).
What is an occurrence code 11?
11 Onset of Symptoms/Illness Code indicates the date patient first became aware of symptoms/illness.
What is the occurrence code on a UB04?
Occurrence codes and their respective dates disclose the payer-specific event(s) related to the billing period on the UB04. They are located in boxes 31 - 36 on the UB04.
What is occurrence code 40 and 41?
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 are Revenue Codes in Medical Billing?
What is a 50 occurrence code?
Occurrence Code 50: Assessment Date is defined as “Code indicating an assessment date as defined by the assessment instrument applicable to this provider type (e.g. Minimum Data Set for skilled nursing). For IRFs, this is the date assessment data was transmitted to the CMS National Assessment Collection Database.”
What is occurrence code 16?
In all cases where an End of Therapy-OMRA is completed, SNFs must submit occurrence code 16, date of last therapy, to indicate the last day of therapy services (e.g. physical therapy, occupational, and speech language pathology) for the beneficiary.
What is occurrence code 24?
If filing for a Conditional Payment, report with Occurrence Code 24. 02. No-Fault Insurance (including automobile and other accidents) – Date of accident/injury for which the state has applicable No-Fault laws. Reported with VC 14 or 47. If filing for a Conditional Payment, report with Occurrence Code 24.
What is occurrence code 18?
FLs 32 thru 36 - Occurrence Codes and Dates.--The following occurrence codes must be completed. where applicable: 18 - Date of retirement (patient/beneficiary) 19 - Date of retirement (spouse) 24 - Date insurance denied.
What is 22 occurrence code?
Occurrence Code 22 (date active care ended) – include the date active care ended; this should match the statement covers through date on the claim. Cover Days and Charges – Submit all covered days and charges as if the beneficiary had days available up until the date active care ended.
What is the occurrence code 30?
Occurrence Code: 30
Date a plan of treatment for outpatient physical therapy was established or last reviewed.
What does occurrence code 17 mean?
17 - Date OT plan of care was established or last reviewed.
What is occurrence code 27?
Hospices report occurrence code (OC) 27 and the date on all notices of election (NOEs) and initial claims following a hospice election. OC 27 and the date are also required on all subsequent claims when the claims From and To dates overlap the first day of the next benefit period.
What is occurrence code 29?
The date the outpatient physical therapy (OPT) plan was established or last reviewed (occurrence code 29) is required on all outpatient claims on which physical therapy (revenue code 42x) is billed.
What is occurrence code 81?
Value Code 81 (Non-Covered Days) Value Code 81 must be used to indicate the total number of full days that are not reimbursable.
What is occurrence code 07?
07 Treatment of Non- terminal Condition for Hospice Code indicates the patient has elected hospice care but the provider is not treating the terminal condition, and is, therefore, requesting regular Medicare payment.
What is occurrence code 70?
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 occurrence code 32 for Medicare?
Occurrence code 32 on a claim signifies that an ABN, Form CMS-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 occurrence code 80?
Occurrence Span Code: 80 Title: Prior Same-SNF Stay Dates for Payment Ban Purposes Definition: The from/through dates of a prior same-SNF stay indicating a patient resided in the SNF prior to, and if applicable, during a payment ban period up until their discharge to a hospital.
What is a 42 occurrence code?
Hospices are to use occurrence code 42 when submitting claims that end the beneficiary's election period not to be confused with discharge status code 42 that indicates to CMS the patient has expired.
What is occurrence code 82?
Occurrence Span Code 82: Hospital at Home Care Dates. "Shall" denotes a mandatory requirement, and "should" denotes an optional requirement.
What is occurrence code 69?
Condition code 69 (teaching hospitals only - code indicates a request for a supplemental payment for Indirect Medical Education/Graduate Medical Education/Nursing and Allied Health)
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 62?
Occurrence code 62 – “Other Institutional Discharge Date” is reported, but not required, on admission claims only, if applicable. This code reports discharge from a SNF, LTCH, IRF, or IPF within 14 days of the “From” date of the HH period of care.