|
Code
|
Description
|
Comment
|
Version
|
| ...
|
See NUBC codes |
|
added v2.5.1 |
| 01
|
Most common semi-private rate |
deprecated |
added v2.3.1, removed after v2.4 |
| 02
|
Hospital has no semi-private rooms |
deprecated |
added v2.3.1, removed after v2.4 |
| 04
|
Inpatient professional component charges which are combined billed |
deprecated |
added v2.3.1, removed after v2.4 |
| 05
|
Professional component included in charges and also billed separate to carrier |
deprecated |
added v2.3.1, removed after v2.4 |
| 06
|
Medicare blood deductible |
deprecated |
added v2.3.1, removed after v2.4 |
| 08
|
Medicare life time reserve amount in the first calendar year |
deprecated |
added v2.3.1, removed after v2.4 |
| 09
|
Medicare co-insurance amount in the first calendar year |
deprecated |
added v2.3.1, removed after v2.4 |
| 10
|
Lifetime reserve amount in the second calendar year |
deprecated |
added v2.3.1, removed after v2.4 |
| 11
|
Co-insurance amount in the second calendar year |
deprecated |
added v2.3.1, removed after v2.4 |
| 12
|
Working aged beneficiary/spouse with employer group health plan |
deprecated |
added v2.3.1, removed after v2.4 |
| 13
|
ESRD beneficiary in a Medicare coordination period with an employer group health plan |
deprecated |
added v2.3.1, removed after v2.4 |
| 14
|
No Fault including auto/other |
deprecated |
added v2.3.1, removed after v2.4 |
| 15
|
Worker's Compensation |
deprecated |
added v2.3.1, removed after v2.4 |
| 16
|
PHS, or other federal agency |
deprecated |
added v2.3.1, removed after v2.4 |
| 17
|
Payer code |
deprecated |
added v2.3.1, removed after v2.4 |
| 21
|
Catastrophic |
deprecated |
added v2.3.1, removed after v2.4 |
| 22
|
Surplus |
deprecated |
added v2.3.1, removed after v2.4 |
| 23
|
Recurring monthly incode |
deprecated |
added v2.3.1, removed after v2.4 |
| 24
|
Medicaid rate code |
deprecated |
added v2.3.1, removed after v2.4 |
| 30
|
Pre-admission testing |
deprecated |
added v2.3.1, removed after v2.4 |
| 31
|
Patient liability amount |
deprecated |
added v2.3.1, removed after v2.4 |
| 37
|
Pints of blood furnished |
deprecated |
added v2.3.1, removed after v2.4 |
| 38
|
Blood deductible pints |
deprecated |
added v2.3.1, removed after v2.4 |
| 39
|
Pints of blood replaced |
deprecated |
added v2.3.1, removed after v2.4 |
| 40
|
New coverage not implemented by HMO (for inpatient service only) |
deprecated |
added v2.3.1, removed after v2.4 |
| 41
|
Black lung |
deprecated |
added v2.3.1, removed after v2.4 |
| 42
|
VA |
deprecated |
added v2.3.1, removed after v2.4 |
| 43
|
Disabled beneficiary under age 64 with LGHP |
deprecated |
added v2.3.1, removed after v2.4 |
| 44
|
Amount provider agreed to accept from primary payer when this amount is less than charges but higher than payment received,, then a Medicare secondary payment is due |
deprecated |
added v2.3.1, removed after v2.4 |
| 45
|
Accident hour |
deprecated |
added v2.3.1, removed after v2.4 |
| 46
|
Number of grace days |
deprecated |
added v2.3.1, removed after v2.4 |
| 47
|
Any liability insurance |
deprecated |
added v2.3.1, removed after v2.4 |
| 48
|
Hemoglobin reading |
deprecated |
added v2.3.1, removed after v2.4 |
| 49
|
Hematocrit reading |
deprecated |
added v2.3.1, removed after v2.4 |
| 50
|
Physical therapy visits |
deprecated |
added v2.3.1, removed after v2.4 |
| 51
|
Occupational therapy visits |
deprecated |
added v2.3.1, removed after v2.4 |
| 52
|
Speech therapy visits |
deprecated |
added v2.3.1, removed after v2.4 |
| 53
|
Cardiac rehab visits |
deprecated |
added v2.3.1, removed after v2.4 |
| 56
|
Skilled nurse - home visit hours |
deprecated |
added v2.3.1, removed after v2.4 |
| 57
|
Home health aide - home visit hours |
deprecated |
added v2.3.1, removed after v2.4 |
| 58
|
Arterial blood gas |
deprecated |
added v2.3.1, removed after v2.4 |
| 59
|
Oxygen saturation |
deprecated |
added v2.3.1, removed after v2.4 |
| 60
|
HHA branch MSA |
deprecated |
added v2.3.1, removed after v2.4 |
| 67
|
Peritoneal dialysis |
deprecated |
added v2.3.1, removed after v2.4 |
| 68
|
EPO-drug |
deprecated |
added v2.3.1, removed after v2.4 |
| 70
|
Payer codes |
deprecated |
added v2.3.1, removed after v2.4 |
| 70 ... 72
|
Payer codes |
deprecated |
added v2.3.1, removed after v2.4 |
| 71
|
Payer codes |
deprecated |
added v2.3.1, removed after v2.4 |
| 72
|
Payer codes |
deprecated |
added v2.3.1, removed after v2.4 |
| 75
|
Payer codes |
deprecated |
added v2.3.1, removed after v2.4 |
| 75 ... 79
|
Payer codes |
deprecated |
added v2.3.1, removed after v2.4 |
| 76
|
Payer codes |
deprecated |
added v2.3.1, removed after v2.4 |
| 77
|
Payer codes |
deprecated |
added v2.3.1, removed after v2.4 |
| 78
|
Payer codes |
deprecated |
added v2.3.1, removed after v2.4 |
| 79
|
Payer codes |
deprecated |
added v2.3.1, removed after v2.4 |
| 80
|
Psychiatric visits |
deprecated |
added v2.3.1, removed after v2.4 |
| 81
|
Visits subject to co-payment |
deprecated |
added v2.3.1, removed after v2.4 |
| A1
|
Deductible payer A |
deprecated |
added v2.3.1, removed after v2.4 |
| A2
|
Coinsurance payer A |
deprecated |
added v2.3.1, removed after v2.4 |
| A3
|
Estimated responsibility payer A |
deprecated |
added v2.3.1, removed after v2.4 |
| X0
|
Service excluded on primary policy |
deprecated |
added v2.3.1, removed after v2.4 |
| X4
|
Supplemental coverage |
deprecated |
added v2.3.1, removed after v2.4 |
| …
|
See NUBC codes |
deprecated |
added v2.7.1, removed after v2.7.1 |