UB-08 / 837I

Question 1

What is a 2 digit code that clarifies an event or condition related to the bill that may affect payer processing.

1. Occurrence Code
2. Occurrence Span Code
3. Condition Code
4. Value Code

Answer 1

Condition Code

Question 2

What is a CONDITION CODE for Information only Bill
A. 08
B. 21
C. 04
D. 24

Answer 2

C. 04

Question 3

What is a CONDITION CODE for beneficiary would not provide INSURANCE info
A. 08
B. 21
C. 04
D. 24

Answer 3

A. 08

Question 4

What is a CONDITION CODE for Billing for Dental notice

A. 08
B. 21
C. 04
D. 24

Answer 4

B. 21

Question 5

What is a 2 digit code and a date that together clarify a significant event or condition related to a claim

1. Occurrence Code
2. Occurrence Span Code
3. Condition Code
4. Value Code

Answer 5

1. Occurrence Code

Question 6

What is an OCCURRENCE CODE for Onset of symptoms / illness

A. 32
B. 24
C. 11

Answer 6

11

Question 7

What is an OCCURRENCE CODE for Date Insurance denied

A. 32
B. 11
C. 24

Answer 7

24

Question 8

What is an OCCURRENCE CODE for Date that an ABN was given

A. 32
B. 11
C. 24

Answer 8

32

Question 9

What is a 2 digit code followed by TWO dates that identify a span of time relevant to claim processing

1. Occurrence Code
2. Occurrence Span Code
3. Condition Code
4. Value Code

Answer 9

Occurrence Span Code

Question 10

What is an OCCURRENCE SPAN CODE for Non-utilization days

A. 74
B. 70
C. 76

Answer 10

70 = Non-utilization days

Question 11

What is an OCCURRENCE SPAN CODE for Noncovered level of care: from/thru dates

A. 74
B. 70
C. 76

Answer 11

74 =Noncovered level of care

Question 12

What is an OCCURRENCE SPAN CODE for Patient liability: From/thru dates of period of noncovered care

A. 74
B. 70
C. 76

Answer 12

76 = Patient Liability - From/thru dates of period of noncovered care

Question 13

What is a 2 digit code and its related amount of value that together clarify an event or condition related to a claim

1. Occurrence Code
2. Occurrence Span Code
3. Condition Code
4. Value Code

Answer 13

Value Code

Question 14

What is a value code for Lifetime Reserve Amount in the first calendar year in billing period

A. 48
B. A0
c. 08

Answer 14

08 = Lifetime Reserve Amount in the first calendar year in billing period

Question 15

What is a value code for Latest hemoglobin reading taken during this billing cycle (Dialysis usage)
A. 48
B. A0
c. 08

Answer 15

48 = atest hemoglobin reading

Question 16

What is a value code for5 digit zip code of ambulance pickup location
A. 48
B. A0
c. 08

Answer 16

A0 = Ambulance pickup zipcode

Question 17

What is a 4 digit code that specifies an accommodation or ancillary service

1. Revenue Code
2. Occurrence Span Code
3. Condition Code
4. Value Code

Answer 17

1. Revenue Code

Question 18

What is the Revenue Code for Room and Board Semi-Private

A. 0120
B. 0310
C. 0450

Answer 18

0120 = Room and Board Semi-Private

Question 19

What is the Revenue Code for Laboratory Pathology General

A. 0120
B. 0310
C. 0450

Answer 19

0310 = Laboratory Pathology General

Question 20

What is the Revenue Code for Emergency Room General

A. 0120
B. 0310
C. 0450

Answer 20

0450 = Emergency Room General