Field # |
Data Element |
7 |
Covered days - applicable if Medicare is a primary or secondary payor |
8 |
Noncovered days - applicable if Medicare is a primary or secondary payor |
9 |
Coinsurance days - applicable if Medicare is a primary or secondary payor |
10 |
Lifetime reserve days - applicable if Medicare is a primary or secondary payor and patient was an inpatient |
21 |
Discharge hour - applicable if patient was an inpatient or was admitted for outpatient observation |
24-30 |
Condition codes - applicable if the HCFA UB-92 manual contains a condition code appropriate to the patient´s condition |
31-36 |
Occurrence codes and dates - applicable if the UCFA UB-92 manual contains an occurrence code appropriate to the patient´s condition |
36 |
Occurrence span code, from and through dates - applicable if the HCFA UB-92 manual contains an occurrence span code appropriate to the patient´s condition |
44 |
HCPCS/Rates - applicable if Medicare is a primary or secondary payor |
54 |
Prior payments - payor and patient - applicable if payments have been made to the provider by or on behalf of the patient or subscriber or by a primary plan |
75 |
Diagnoses codes other than principal diagnosis code - applicable of there are diagnoses other than the principal diagnosis |
79 |
Procedure coding methods used - applicable if the HCFA UB-92 manual indicates a procedural coding method appropriate to the patient´s condition |
80 |
Principal procedure code - applicable if patient has undergone an inpatient or outpatient surgical procedure |
81 |
Other procedure code - applicable as an extension of field 80 if additional surgical procedures were performed |