WebCode Notes See Form Locator 80 for Reason for Adjustment Codes to be used with this ... 17 Patient Discharge Status ... Status Codes, please refer to the UB-04 Desk Reference, located in Appendix A of the handbook. 18–28 Condition Codes A Enter the appropriate condition codes in Form Locators 18 through 28. WebPlease note that in the instructions, FL stands for Form Locator and is used to describe the ... FL 17 – Patient Discharge Status Required. (For all Part A inpatient, SNF, hospice, home health ... See Resource 188 for the complete list of FL 17 codes (available by subscription only). FLs 18 - 28 – Condition Codes
UB-04 Claim Form Instructions - Geisinger
WebFeb 20, 2024 · Form locator 17: Discharge status using the two-digit codes from the NUBC manual. Form locator 18-28: Condition codes using the two-digit codes from the NUBC manual for up to 11 occurrences. Form locator 29: Accident state (if applicable) using a two-digit state code Form locator 30: Accident date WebUB-04 Boxes (Form Locator) Many of the fields for the UB-04 form need to be added manually to the grids. ... 17. Patient Status (STAT) Claim > Patient Status 18-21. Condition Codes. Claim Condition Code 1-4. Only … the priority for any first aider should be:
Form CA-17 Duty Status Report - TemplateRoller
WebIf one of the codes below is used, a Status Code from the table above must still be entered in FL22. 13 - Hospital Leave will be revenue code 0185 in FL 42. 14 - Therapeutic Leave will be revenue code 0183 in FL 42. Child Care only 16 – AWOL will be revenue code 0189 in FL 42. 17 – Trial Discharge will be revenue code 0180 in FL 42. Web16 Discharge Hour LB Do not complete this form locator. 17 Patient Discharge Status LB Do not complete this form locator. 18–28 Condition Codes A Enter the appropriate condition codes in Form Locators 18 through 28. For a complete listing and description of Condition Codes, please refer to the UB-04 Desk Reference, WebApr 4, 2024 · Form Locator 17 — Patient Discharge Status ... Refer to personal care publications or the UB-04 Billing Manual for information and codes. Form Locator 43 — Description Do not enter any dates in this form locator. Form Locator 44 — HCPCS/Rate/HIPPS Code Enter the appropriate five-digit procedure code and the … sigmato thermi