What is the occurrence code for date of death?

Occurrence Code 55 is the standardized administrative code used on medical claims (such as UB-04 forms) to report the date of a patient's death.

Key Usage Details

• Required Usage: Report Occurrence Code 55 alongside the exact date of death whenever a patient's discharge status is coded as expired.
• Discharge Status Codes: Commonly paired with patient discharge status codes 20 (expired), 40 (expired at home), 41 (expired in a medical facility), or 42 (place of death unknown).
• Claim Adjustments: If a date of death was reported in error or needs correction, providers must submit a CMS Claim Adjustment to update or remove Occurrence Code 55.

Occurrence code 42 means the date of discharge or hospice termination/revocation on medical and insurance claims.

Usage and Contexts

• Hospice Claims: Defined by the National Uniform Billing Committee (NUBC) as the date a Medicare beneficiary revokes or terminates their election of hospice care, or when a provider-terminated discharge happens (such as when a patient is no longer considered terminally ill). It ends the current hospice benefit period as of that specific date.
• General/Medicaid Claims: Used by certain state programs or payers to indicate a live date of discharge from a facility.

(Note: If you are looking at hospital inpatient billing rather than occurrence codes, Condition Code 42 is different—it is used when a patient is discharged home with home health services that are unrelated to the inpatient hospital diagnosis.)

Occurrence code 22 means the Date Active Care Ended on institutional claims (such as Skilled Nursing Facility or hospital settings).

What is Occurrence Code 22?

• Definition: It shows the exact date when a covered level of care ended in a skilled nursing facility (SNF), general hospital, psychiatric hospital, tuberculosis hospital, or when a patient was released on a trial basis from a residential facility.
• Usage Rule: You do not need to report code 22 if you already use occurrence code 21.
• Billing Impact: It helps payers verify eligibility periods and coordinate benefits correctly. For official guidelines, check the Noridian Medicare Occurrence Codes Guide.

In medical billing and claims, Occurrence Code 45 stands for the Date Treatment Started for Speech Therapy on outpatient claims.

(Note: If you are looking at an insurance denial or adjustment message rather than an occurrence code on a claim form, CO 45 instead means "Charges Exceed Contractual Agreement," which is a contractual write-off rather than a true denial).

Key Details for Occurrence Code 45

• Definition: The exact date when speech-language pathology (speech therapy) treatment began.
• Usage: Used on institutional outpatient claims (such as hospital outpatient or comprehensive outpatient rehabilitation facilities).
• Format: Entered as a two-digit code (45) alongside the specific calendar date the service started.

Occurrence Span Code 74 (often referred to as an occurrence or span code 74) is a medical billing code that reports the "from" and "through" dates for a period of a non-covered level of care or a temporary leave of absence (LOA) during an otherwise covered hospital or facility stay.

Key Details and Usage

• Leave of Absence (LOA): Shows when a patient temporarily leaves a facility (such as a skilled nursing facility or inpatient rehab) for personal reasons or a brief hospital visit.
• Billing Accuracy: Prevents facilities from billing insurance or Medicare for days when the patient was not physically present or receiving care.
• Repetitive Part B Services: Also used on outpatient or institutional claims to show a specific period of inpatient care or outpatient surgery that happens during a broader billing cycle.