(Medicare Claims Processing Manual Crosswalk)

Secondary Identifier Qualifiers:   0B - State License Number   1G - Provider UPIN Number   G2  Provider Commercial Number   FL 80  Remarks   Situational.  For DME billings the provider shows the rental rate, cost, and anticipated months of usage so that the providers A/B MAC (A or HH H) may determine whether to approve the rental or purchase of the equipment.  Where Medicare is not the primary payer because WC, automobile medical, no-fault, liability insurer or an EGHP is primary, the provider enters special annotations.  In addition, the provider enters any remarks needed to provide information that is not shown elsewhere on the bill but which is necessary for proper payment.  For Renal Dialysis Facilities, the provider enters the first month of the 30-month period during which Medicare benefits are secondary to benefits payable under an EGHP. (See Occurrence Code 33.)   FL 81 - Code -Code Field   Situational.  To report additional codes related to a Form Locator or to report external code list approved by the NUBC for inclusion to the institutional data set.   Codes used for Medicare claims are available from Medicare contractors.  Codes are also available from the NUBC (www.nubc.org) via the NUBCs Official UB-04 Data Specifications Manual.  80  Reserved  Transmittals Issued for this Chapter  Rev #  Issue Date  Subject  Impl Date  CR#  R12423CP  12/20/2023  Enforcing Billing Requirements for Intensive Outpatient Program (IOP) Services with New Condition Code 92  01/02/2024  13222  R10880CP  08/06/2021  Internet Only Manual Updates to Pub. 100-01, 100- 02, and 100- 04 to Implement Consolidated Appropriations Act Changes and Correct Errors and Omissions (SNF)  11/08/2021  12009 R4194CP  01/11/2019  Update to Publication (Pub.) 100- 04 Chapter 25 to Provide Language -Only Changes for the New Medicare Card Project  02/12/2019  11091 R3709CP  02/03/2017  Internet Only Manual (IOM) Chapter 25 Revision 04/04/2017  9964 R3435CP  12/31/2015  Clarification on Patients Reason for Visit Necessary to Capture HIPAA Compliant Fields  03/31/2016  9450 R2922CP  04/03/2014  Medicare Claims Processing Pub. 100- 04 Chapter 25 Update  04/18/2014  8577 R2874CP  02/06/2014  Medicare Claims Processing Pub. 100- 04 Chapter 25 Update  Rescinded and replaced by Transmittal 2922 03/07/2014  8577 R2683CP  04/05/2013  Non-systems Internet Only Manual (IOM) Changes  06/05/2013  8220 R2250CP  07/01/2011  Non-systems Internet Only Manual (IOM) Changes  08/01/2011  7437 R1973CP  05/21/2010  Internet Only Manual (IOM) Chapter 25 Revisions  09/01/2010  6907 R1946CP  04/15/2010  Billing and Processing Claims with Unlimited Occurrence Span Codes (OSCs)  07/06/2010  6777 Rev #  Issue Date  Subject  Impl Date  CR#  R1934CP  03/19/2010  Billing and Processing Claims with Unlimited Occurrence Span Codes (OSCs)  Rescinded and replaced by Transmittal 1946 07/06/2010  6777 R1932CP  03/17/2010  Dialysis Adequacy, Infection and Vascular Access Reporting  07/06/2010  6782 R1929CP  03/09/2010  Point of Origin for Admission or Visit Codes Update to the UB -04 (CMS -1450) Manual Code List  07/06/2010  6801 1917CP  02/05/2010  Point of Origin for Admission or Visit Codes Update to the UB -04 (CMS -1450) Manual Code List -  Rescinded and replaced by Transmittal 1929 07/06/2010  6801 R1915CP  02/05/2010  Non-systems Internet Only Manual Chapter 25 Changes  04/14/2010  6788 R1898CP  01/29/2010  Dialysis Adequacy, Infection and Vascular Access Reporting  - Rescinded and replaced by Transmittal 1932 07/06/2010  6782 R1877CP  12/18/2009  Instructions Regarding Processing Claims Rejecting for Gender/Procedure Conflict  04/05/2010  6638 R1839CP  10/28/2009  Instructions Regarding Processing Claims Rejecting for Gender/Procedure Conflict - Rescinded and replaced by Transmittal 1877 04/05/2010  6638 R1775CP  07/24/2009  Point of Origin Codes Update to the UB -04 (CMS -1450) Manual Code List  01/04/2010  6478 R1767CP  07/10/2009  IOM Chapter 25 Revenue Code 076X Description Change  08/10/2009  6561 R1718CP  04/24/2009  New Patient Discharge Status Code 21 to Define Discharges or Transfers to Court/Law Enforcement  10/05/2009  6385 Rev #  Issue Date  Subject  Impl Date  CR#  R1555CP  07/18/2008  Revision of the Requirements for Denial of Payment for New Admissions (DPNA) for Skilled Nursing Facility (SNF) Billing  01/05/2009  6116 R1496CP  05/02/2008  Medicare Shared Systems Modifications Necessary to Capture and Crossover Medicaid Drug Rebate Data Submitted on form UB -04 Paper Claims and Direct Data Entry (DDE) Claims  10/06/2008  5950 R1395CP  12/14/2007  Updated National Uniform Billing Committee (NUBC) Codes and Other Internet Only Manual Chapter 25 Revisions  01/07/2008  5850 R1361CP  11/02/2007  New Patient Status Discharge Code 70 to Define Discharges or Transfers to Other Types of Health Care Institutions not Defined Elsewhere in the UB -04 (CMS -1450) Manual Code List  04/07/2008  5764 R1254CP  05/25/2007  National Uniform Billing Committee (NUBC) Update to Chapter 25 06/11/2007  5593 R1104CP  11/03/2006  Uniform Billing (UB -04) Implementation 03/01/2007  5072 R1078CP  10/13/2006  Updating the Medicare Secondary Payer (MSP) Manual for Consistency on Instructing Part A Contactors on Handling MSP Claims with Condition Code (cc) 08  04/02/2007  5266 R1018CP  07/28/2006  Uniform Billing (UB -04) Implementation 03/01/2007  5072 R980CP  06/14/2006  Changes Conforming to CR 3648 Instructions for Therapy Services -  Replaces Rev. 941 10/02/2006  4014 R941CP  05/05/2006  Changes Conforming to CR 3648 Instructions for Therapy Services  10/02/2006  4014 Rev #  Issue Date  Subject  Impl Date  CR#  R901CP  04/07/2006  New National Uniform Billing Committee (NUBC) Codes and Other Chapter 25 Revisions  05/08/2006  4384 R529CP  04/22/2005  Update to Current National Uniform Billing Committee (NUBC) Codes.  07/05/2005  3794 R493CP  03/04/2005  Revision to Chapter 1 and Removal of Section 70 from Chapter 25 of the Medicare Claims Processing Manual  04/04/2005  3671 R368CP  11/12/2004  Instructions for Completion of Form CMS -1450 04/04/2005  3543 R311CP  10/08/2004  Relocation of Sections 20 and 30 to Chapter 24  Clarification of Noncovered Days, Patient Status Codes and Revenue Codes   New Condition Codes and Value Codes  1/5/2005 3417 R303CP  09/24/2004  Relocation of Sections 20 and 30 to Chapter 24  Clarification of Noncovered Days, Patient Status Codes and Revenue Codes   New Condition Codes and Value Codes  01/05/2005  3417 R199CP  06/10/2004  Rejection of Any Outpatient Claim Containing a Range of Dates in the Line Item Date of Service (LIDOS) Field  10/04/2004  3337 R167CP  4/30/2004 Replacement of Revenue Code 0910 by Revenue Code 0900 to Report Certain Psychiatric/ Psychological Treatment and Services.   Addition of Provider Range 4900- 4999 to the Applicable Provider Ranges for Community Mental Health Centers  10/04/2004  3194 Rev #  Issue Date  Subject  Impl Date  CR#  R149CP  04/23/2004  Update for New Condition Code, and to Clarify Patient Status Codes and Revenue Code 0910 10/04/2004  3183 R107CP  02/24/2004  Changes in X12N937 Institutional Edits  07/06/2004  3031 R081CP  02/06/2004  New Condition and Value Codes Approved by the National Uniform Billing Committee (NUBC) and Addition of All NUBC Approved Codes that Were Not Previously in Medicare Instructions, to Be Complaint With the HIPAA Requirements  07/06/2004  3012 R001CP  10/01/2003  Initial Publication of Manual  NA NA Back to top of chapter