Easily Remove Conditional Fields from the Patient Discharge Form

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How to Remove Conditional Fields from the Patient Discharge Form

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Welcome to PDF Run! In this video, well guide you on how to fill out a Hospital Discharge Paper! A Discharge Paper is a sample form only for patients who are ready to leave the clinic or hospital. Before discharging patients from the hospital, certain information must be on file. For this purpose, a discharge paper may help to gather patient information, follow-up plan, and any other data needed for a successful discharge. Discharge papers must be kept confidential by hospitals or clinics as it contains detailed information about the patient. This discharge form is simple and straightforward. It contains six parts: Patient Details, Primary Healthcare Professional Details, Admission and Discharge Details, Diagnosis and Procedures, Medication Details, and Prepared by section. To fill out the Discharge Paper, click on the Fill Online button. This will redirect you to PDF Runs online editor. For the first section, enter the required details of the patient. To start, input the first name.

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Below are some common questions from our customers that may provide you with the answer you're looking for. If you can't find an answer to your question, please don't hesitate to reach out to us.

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What is box 74 on UB04?

Box 74 is for the principal procedure code and date. It is required on inpatient claims where a procedure is performed. It is not used on outpatient claims. Hope that is helpful! Donna.

What is discharge status condition code?

A patient discharge status code is a two-digit code that identifies where the patient is at the conclusion of a health care facility encounter or at the end of a billing cycle (the through date of a claim).

Where do I put my authorization number on UB04?

If you are billing on a UB04, the authorization number can also be entered on the patients claim by navigating to Billing Live Claims Feed Inside the patients claim right side of the screen Insurance tab. Authorizations for the patients primary payer (red box) and secondary payer (blue box) can be entered.

What is condition code 65?

65 Non-PPS bill not reported by providers. MAC records this from system for non-PPS hospital bills.

What goes in box 76 on UB04?

The information in box 76 should just reflect the name and NPI of the provider who is responsible for admitting the patient or overseeing the care.

What is a discharge summary patient condition?

A discharge summary refers to a clinical report prepared by health professionals that outlines the details of the hospitalization of a patient. Lack of discharge details, diagnosis information or patients health status in discharge summaries can lead to poor treatment plans.

What goes in box 39 on UB04?

Box 39-41; a-d Value codes and amounts: (Optional) Use these locators to indicate codes and amounts essential to the proper adjudication of the submitted claim. Each form locator contains a three digit field in which to key the indicator code, and a larger free text field in which to designate an applicable amount.

What is field 17 on UB04?

17 Patient Status Required. This code indicates the patients status as of the Through date of the billing period (Field 6). 18-28 Condition Codes Leave blank.

What is box 72 on a UB04?

72. External Cause of Injury Code Enter the ICD-9-CM diagnosis code pertaining to external cause of injuries. 74. Principal Procedure Code and Date Enter the ICD code that identifies the principal procedure performed. Enter the date of that procedure.

What goes in box 72 on UB04?

LOCATOR 72 EXTERNAL CAUSE OF INJURY CODE Enter the diagnosis code for the external cause of an injury, poisoning, or adverse effect. LOCATOR 73 UNLABELED FIELD Leave blank. Enter the procedure code identifying the principal surgical or obstetrical procedure in locator 74. Enter other procedure codes in locators A-E.

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