What is occurrence code 48?
Asked by: Dr. Muhammad Lakin | Last update: July 21, 2025Score: 4.3/5 (65 votes)
What is value code 48 and 49?
Effective January 1, 2006 the definition of value code 48 is changed to indicate the patient's most recent hemoglobin reading taken before the start of the billing period. 49 - Hematocrit Reading - Code indicates the hematocrit reading taken before the last administration of EPO during this billing cycle.
What is an occurrence code on a claim?
Definition. 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.)
What is 47 occurrence code?
Occurrence code 47 -- indicates the first day the inpatient cost outlier threshold is reached or the date after the DRG cutoff date.
What does occurrence code 04 indicate?
04 Accident/Employment Code indicates the date of accident relating to the Related patient's employment.
OCCURRENCE CODES IN MEDICAL BILLING #UB04 #rcmservices #RCMl #insurance #providers #patient
What is a 42 occurrence code?
Enter this code to indicate that an Advance Beneficiary Notice (ABN) was required AND the beneficiary demanded you submit the claim to Medicare for review. Include the date the ABN was signed by the beneficiary. Occurrence code 42 is only required when the patient revokes their hospice election.
What is occurrence code 46?
46. Date Treatment Started for Cardiac Rehabilitation. Beneficiary must have regular coinsurance and/or lifetime reserve days available beginning on this date to allow coverage of additional daily charges to receive cost outlier payments.
What is occurrence code 50?
These codes are claim-related occurrences that are related to a time period (span of dates). Tips: 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.
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 45?
45 Date treatment started for speech therapy - Code indicates the date services were initiated by the billing provider for speech therapy.
What is 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 56?
The hospice must submit an NOE that corrects the “from” and “admit” dates previously submitted in error. In this case, the hospice reports the correct election date in the “from” and “admit” date fields and reports the incorrect election date using occurrence code 56.
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 condition code 48?
48 - Hemoglobin Reading - Code indicates the hemoglobin reading taken before the last administration of Erythropoietin (EPO) during this billing cycle. This is usually reported in three positions with a decimal.
What is reason code 49?
Denial code 49 is used to indicate that a specific service is not covered by the insurance provider. In this case, it is because the service falls under the category of a routine/preventive exam or a diagnostic/screening procedure done in conjunction with a routine/preventive exam.
What is occurrence code 72?
For example, occurrence span code 72 is used for representing the first and last dates of service in the case of outpatient services, when the entire billing record does not represent the actual dates of service.
What is occurrence code 47?
Occurrence code (OC) 47 -- a code that indicates the first day the inpatient cost outlier threshold is reached or the date after the DRG cutoff date.
What are the three accident occurrence codes?
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 is occurrence code 55?
Medicare systems shall accept and process new occurrence code 55 used to report date of death.
What is value code 51?
51 Occupational therapy visits - Indicates the number of occupational therapy visits from onset (at the billing provider) through this billing period. 52 Speech therapy visits - Indicates the number of speech therapy visits from onset (at billing provider) through this billing period.
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.
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 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.