What is a condition code on a UB04?

Condition codes refer to specific form locators in the UB-04 form that demand to describe the conditions applicable to the billing period. It is important to note that condition codes are situational. These codes should be entered in an alphanumeric sequence.

What does condition code 41 mean?

partial hospitalization services
All hospitals, including CAHs, report condition code 41 to indicate the claim is for partial hospitalization services.

What condition code is for not hospice related?

07
Hospice services covered under the Medicare hospice benefit are billed by the Medicare hospice. Institutional providers may submit claims to Medicare with the condition code “07” when services provided are not related to the treatment of the terminal condition.

What is a code 44?

Condition Code 44 When a physician orders an inpatient admission, but the hospital’s utilization review committee determines that the level of care does not meet admission criteria, the hospital may change the status to outpatient only when certain criteria are met.

What does condition code 45 mean?

Ambiguous Gender Category
CR 6638 instructs that for Part A claims processing, institutional providers should report condition code 45 (Ambiguous Gender Category) on inpatient or outpatient services that can be subjected to gender specific editing (i.e., services that are considered female or male only) for the above defined beneficiaries.

What is condition code D9?

D9 Condition Code Use the D9 claim change reason code on an adjustment claim to reflect any other changes to be made to a claim that was already processed: Adjustment to a claim when an original claim was rejected for Medicare Secondary Payer (MSP) but Medicare is primary.

What is Condition C at UPMC?

UPMC Codes Condition C: Called when a patient is in crisis and needs rapid evaluation and treatment or when a patient requires expedient transfer to a monitored bed or an ICU bed.