What is code 70 on UB04?

• Accident/medical coverage.
• No-fault insurance, including auto.
• Accident, tort liability.
• Accident, employment-related.
• Accident/no medical or liability cov.
• Crime victim.

What is occurrence code 77?

When the recertification is not done timely, an occurrence span code (OSC) 77 must be reported to represent for the days that are provider-liable due to the late recertification. The OC 27 is reported with the date that the actual recertification was obtained.

What is UB condition code 77?

77 Provider accepts or is obligated/required, due to a contractual arrangement/law, to accept payment by primary payer as payment in full (and that amount has been received and no Medicare payment is due).

What goes in box 70 on ub04?

70. Patient's Reason for Visit Enter the ICD-9-CM diagnosis code that describes the patient's reason for visit. 71. PPS Code The PPS code assigned to the claim.

What is the condition code 71?

71 - Full Care in Unit - Providers enter this code to indicate the billing is for a patient who received staff-assisted dialysis services in a hospital or renal dialysis facility.

What is condition 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 status code 50?

50 (Discharged/transferred to hospice - home) 51 (Discharged/transferred to hospice - medical facility)

What is value code 80?

Note: Value code 80 is used to report a combined total of the beneficiary's full days and coinsurance and lifetime reserve days, as applicable. • Value code 81 -- Non-covered days. Description: Days of care not covered by the primary payer. • Value code 82 -- Co-insurance days.

What is medical code 27?

Modifier 27 is for hospital/outpatient facilities to use when multiple outpatient hospital evaluation and management (E/M) encounters occur for the same beneficiary on the same date of service.

What is a 63 discharge code?

63 Discharged/transferred to a Medicare-certified long-term care hospital. Usage Note: For hospitals that meet the Medicare criteria for LTCH certification. Long-term care hospitals are certified under Medicare as short-term acute care hospitals with an average inpatient LOS greater than 25 days.

What is a 65 discharge code?

61 Discharged/transferred within this institution to a hospital based Medicare approved swing bed. 65 Discharged/transferred to a psychiatric hospital or psychiatric distinct part unit of a hospital.

What is discharge code 55?

This CR requires that hospice agencies report occurrence code 55 to report date of death. If a discharge status code of 40 (expired at home), 41 (expired in medical facility), or 42 (expired – place unknown) is present on a hospice claim, occurrence code 55 with date of death must also be present on the claim.

What is condition code 72?

This code is commonly used to indicate that the patient has passed two necessary midnights in the hospital, but less than two as inpatient. This code will not exempt the admission from audit, but it doesn't necessarily indicate that auditing these cases will result in an automatic denial.

What is condition code 64?

Enter condition code 64 to indicate that the claim is not a "clean" claim, and therefore, not subject to the mandated claims processing timeliness standard. 5. Interest Payment on Clean Non-PIP Claims, Not Paid Timely.

What is physician identifier code 71?

2310A NM101 Entity Identifier Code 71 When code 71 is used, the term physician covers any type of provider filling this role. 2310A NM103 Attending Provider Last Name The attending provider is the individual who has overall responsibility for the patient's medical care and treatment reported on the claim/encounter.

What is box 71 on a ub04?

71 Prospective Payment System (PPS) Code Not required This code identifies the DRG based on the grouper software and is required only when the provider is under contract with a health plan using DRG codes.

What is code 80 on ub04?

The number of covered days (value code 80) must match the number of units and charges reported for the covered room and board days. Claims to be paid by Per Diem reimbursement should have the appropriate covered days reported to match the authorization. C. Make sure that the value code are in numerical order.

How many diagnosis codes are on ub04?

67 Principal Diagnosis Code on Admission Enter the appropriate ICD diagnosis code that describes the nature of the illness or injury. 67A - Q Other Diagnosis Codes Enter up to 16 ICD codes for other diagnoses.

What is facility code 73?

Modifier -73 is used by the facility to indicate that a surgical or diagnostic procedure requiring anesthesia was terminated due to extenuating circumstances or to circumstances that threatened the well being of the patient after the patient had been prepared for the procedure (including procedural pre-medication when ...

What is condition code 30?

Condition Code 30 means "Qualified Clinical Trial". It must appear on the hospital inpatient or outpatient claim when billing for items/services related to a Qualified Clinical Trial or qualified study regardless of whether all services on the claim are related to the clinical trial or not.

What is Medicare ub04 value code 73?

73 – Sequestration adjustment amount. 74 – Low volume hospital payment amount 75 – Prior covered days for an interrupted stay.