What does occurrence code mean?
Asked by: Prof. Erna Kirlin Jr. | Last update: September 24, 2025Score: 4.7/5 (49 votes)
What is an occurrence code?
The code that identifies a significant event relating to an institutional claim that may affect payer processing.
What does occurrence code 24 mean?
AN OCCURRENCE CODE 24 IS PRESENT ON THE CLAIM; HOWEVER, NO VALUE CODE IS PRESENT OR YOU ARE BILLING FOR A MEDICARE PRIMARY PAYMENT. THERE IS AN OCCURRENCE CODE 24 ON THE CLAIM AND YOUR REMARKS DO NOT SUFFICIENTLY EXPLAIN WHY THE PRIMARY INSURER DID NOT PAY THIS CLAIM.
What does occurrence mean in insurance?
In insurance, an occurrence is defined as “an accident, including continuous or repeated exposure to substantially the same general harmful conditions.”
What does occurrence code 50 mean?
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)
OCCURRENCE CODES IN MEDICAL BILLING #UB04 #rcmservices #RCMl #insurance #providers #patient
What does occurrence code 70 mean?
Definition. • OSC 70 -- Non-utilization dates (for payer use on hospital bills only). The from/through dates during a prospective payment system (PPS) inlier stay for which the beneficiary has exhausted all regular days and/or coinsurance days, but which is covered on the cost report.
What is a reason code 50?
Denial code 50 means the service is not covered because it's not considered medically necessary by the insurance company.
What is an example of occurrence?
Street-fights are an everyday occurrence in this area of the city. Death was an everyday occurrence during the Civil War. It's still not possible to accurately predict the occurrence of earthquakes. There have been several occurrences of theft in the area recently.
Do I want occurrence or claims-made?
A claims-made policy only covers those that occur and are reported within the policy's timeframe, unless tail coverage is also purchased. An occurrence policy provides lifetime coverage for incidents that take place during a policy period, regardless of when the claim is reported.
What is the difference between an accident and an occurrence?
The term "occurrence" encompasses more than just an accident because accident is narrower in scope than occurrence. This can be seen in those cases decided before the occurrence wording was adopted. Accident, according to these cases, did not include coverage for damage occurring over time.
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 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 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 24?
If filing for a Conditional Payment, report with Occurrence Code 24. Date Insurance denied - Date of receipt of a denial of coverage by a higher priority payer. This could be date of primary payer's Explanation of Benefit (EOB) statement, letter or other documentation.
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 does occurrence code 22 mean?
iii) Occurrence Code 22 (date active care ended, i.e., date covered SNF level of care ended) = include the date active care ended; this should match the statement covers through date on the claim.
What counts as an occurrence?
An occurrence is an unscheduled absence or late arrival (Not protected by FMLA, WC, etc.). For example, arriving 30 minutes late would count as an occurrence and calling in to use sick leave, vacation, or comp time for a day would be an occurrence.
What is an example of an occurrence in insurance?
Any accident or incident that can harm a person or their property may count as an occurrence. If a third party trips over a toolbox left sitting at your building site and injures themself, that's an occurrence. However, if the damage or injury is caused on purpose, your liability insurance won't cover you.
Can you switch from occurrence to claims made?
Claims-Made policies provide coverage for 'claims' only when BOTH the alleged incident AND the resulting 'claim' happen during the period the policy is in force! Switching from an "Occurrence" to a "Claims Made" form is the least perilous change.
Does occurrence mean incident?
occurrence, event, incident, episode, circumstance mean something that happens or takes place. occurrence may apply to a happening without intent, volition, or plan. an encounter that was a chance occurrence. event usually implies an occurrence of some importance and frequently one having antecedent cause.
What is the meaning of payment occurrence?
Payment Occurrence means the settlement or final adjudication (without any ability to further appeal by either party) as to all demands, claims, counterclaims, cross-claims, third-party-claims, damages, fees (including attorneys' fees), costs and expenses, brought and raised, on any matters arising from or related to ...
What is occurrence also known as?
Some common synonyms of occurrence are circumstance, episode, event, and incident. While all these words mean "something that happens or takes place," occurrence may apply to a happening without intent, volition, or plan.
What is a reason code?
A reason code is a predefined set of categories or codes used to classify and track the reasons why certain events or transactions occur in a business.
What is a 13.7 reason code?
Visa chargeback reason code 13.7 falls under the “Consumer Disputes” category. The shorthand description is “Cancelled Merchandise/Services.” This code indicates that the cardholder claims they returned merchandise or canceled their services with the merchant, but did not receive a refund.