Hospital Billing Codes
Revenue Codes:
Condition Codes:
Occurrence Codes:
Occurrence Span Codes:
Value Codes:
- These codes describe the type & the location of the service.
- For example: 0450 - Emergency Room General Services, 0300 – Laboratory General Services, etc.
- These are 4 digis codes.
- It is used in locator 42 on UB-04 form.
- These codes describe specific circumstances or situations of patient's care.
- For example: 02 - Condition is employment related, 17 - Patient is homeless, etc.
- These are 2 digits codes.
- It is used in locators 18-28 on UB-04 form.
- These codes describe specific dates & events that occurred during patient treatment.
- For example: 01 - Auto Accident Date, 02 - Date of illness or injury, etc.
- These are 2 digits codes.
- It is used in locators 31-34 on UB-04 form.
- These codes describe the span of the particular service or events provided to the patient.
- For example: 77 - Hospital stay start date, 78 - Hospital stay end date, etc.
- These are 2 digits codes.
- It is used in locators 35-36 on UB-04 form.
- These codes provide additional monetary information related to a patient's care or services.
- For example: 01 - Patient's age, 18 - Number of covered days, etc.
- These are 2 digits codes.
- It is used in locators 39-41 on UB-04 form.
TOB (Type Of Bill):
- TOB helps payers to quickly identify the claim type for processing and reimbursement.
- These are 4 digits codes and each digit has a specific reason which is very important while submission.
- 1st digit: It is always 0.
- 2nd digit: Indicates type of facility. Examples - Hospital, RHC, SNF etc.
- 3rd digit: Type of care. Examples - Inpatient, outpatient etc.
- 4th digit: Indicates claim frequency. Examples - Original, adjustment etc.
- It is used in locator 4 on UB-04 form.
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Hello, can you pls verify the value code 18 mention is for the covered days, but for it we have value code 80.
ReplyDeleteBoth codes reflect covered days, but Value Code 18 applies to inpatient facilities, while Value Code 80 is specific to SNF services.
Deletehi,
ReplyDeletecan you please update the home health billing interview questions,diagnosis,cpt,hipps codes,types of bill,status codes.
Sure, we will review this and plan to create a post on home health billing interview questions.
DeleteMore hospital billing interview questions can u start the series of Q&A session
ReplyDeleteI am from hospital billing UB04 background
Need more scenarios on denials related underpayment, denials on hospital,fee schedule,drg payments ..
Appreciated your emmense response n support Thanks. :)
Sure! You can post your question here or send it to us on WhatsApp +91 8097279620.
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