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Value Codes CodeDescription 44 Amount provider agreed to accept from primary payer when amount is charges but higher than payment received 45 Accident hour 46 Number of grace days following QIO / UR determination 47 Any liability insurance (Payer Code L)142 more rows 9 Dec 2023
What are UB04 bill types?
UB04 Box 4 - Type of Bill on an institutional claim 1- Hospital. 2- Skilled Nursing Facility. 3- Home Health. 4- Christian Science (Hospital) 5- Christian Science (Extended Care) 6- Intermediate Care. 7- Clinic. 8- Special Facility.
What is value code A0?
A0. Special Zip Code Reporting. Five digit ZIP Code of the location from which the beneficiary is initially placed on board the ambulance.
What is the condition code 74 for dialysis patients?
74 Home Providers enter this code to indicate the billing is for a patient who received dialysis services at home. 76 - Back-up In-facility Dialysis - Providers enter this code to indicate the billing is for a home dialysis patient who received back-up dialysis in a facility.
What is the value code amount?
The value code amount is the Designated State Level Medicaid Rate Code (DSLMRC), which identifies the type of facility that the patient resides and the level of care the patient receives.
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For institutional claims the hemoglobin reading is reported with a value code 48 and a hematocrit reading is reported with the value code 49.
What is value code 49 on UB 04?
49 - Hematocrit Reading - Code indicates the hematocrit reading taken before the last administration of EPO during this billing cycle. This is usually reported in two positions (a percentage) to the left of the dollar/cents delimiter.
What are value codes on a UB04?
Value codes are required on an institutional claim to identify data elements such as: Medicare lifetime reserve days, no-fault payments, and the number of days not covered by the primary payer.
Related links
Room Change Request Process 2020-2021
request form along with the Room Change Request form. Submitting a Room Change Request Form. 1. To submit housing.berkeley.edu (p) 510-642-4108 (f) 510
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