What Is Condition Code in Ub04

CMS1450/UB04 Fields: 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, and 28 are places for Condition Codes. The provider enters the corresponding code (in numerical order) to describe any conditions or events that apply to the billing period.

What is a condition code?

Currently, Condition Codes are designed to allow the collection of information related to the patient, particular services, service venue and billing parameters which impact the processing of an Institutional claim. … These codes are integral to the institutional claim, both the paper UB and the electronic 837I.

What is condition code M0?

CodeDescriptionM0All-inclusive rate for outpatient services.M1Roster billed influenza virus vaccine or pneumococcal pneumonia vaccine (PPV).M3SNF 3 day stay bypass for NG/Pioneer ACD waiver.MAGastroenteritis (GI) bleed (acute comorbid).

Sophia Al-Mansoor

Sophia Al-Mansoor

Global Business & E-Commerce Reporter

Sophia analyzes international trade, startup ecosystems, retail transformation, and supply chain logistics for modern digital publications.

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