Condition Code 58 for Medicare (pdf download)

Medicare Secondary Payer Billing & Adjustments – CGS
using Process A. If payment denied or applied to deductible, bill Medicare ….
Enter your provider number for the primary payer (if known), on line A. FL 58 …. If
WC, enter condition code ’02’ to indicate the condition is employment related.

Home Health Medicare Billing Codes Sheet – CGS
Other value codes may be required when Medicare is the secondary payer. See
the …. U538I Enter condition code 47 to indicate transfer between HHAs … 58.
Insured’s last name, first name. N. C5. 5. SEX. N/A. Insured’s sex code. N. C5. 5.

Medicare Secondary Payer (MSP) Billing – Cahaba GBA
Medicare secondary using Process B. If payment denied, bill. Medicare
conditionally …. INSURED NAME FL 58. Enter the Insured‟s …. If WC, enter
condition code „02‟ to indicate the condition is employment related. 1. OCC CDS
/DATE FL …

http://www.dpw.state.pa.us/cs/groups/webcontent/documents/manual/s_001889.pdf
UB-04 Billing Guide for PROMISe™ Intermediate Care Facilities for …
Jun 17, 2013 … days are Medicare Coinsurance Days and there were 30 days in the service
period; enter 30 with the … Form Locators 18 – 28 (Condition Codes) – Enter X2.
….. provider number. Do not use slashes, hyphens, or spaces. 58.

http://www.eohhs.ri.gov/Portals/0/Uploads/Documents/ub04_instructions.pdf
UB-04 Claim Form Instructions
Enter the four digit code that identifies the specific type of bill and … 1 = Inpatient (
Including Medicare Part A) …. occurrences to identify conditions that may affect ….
Medicaid” payer information is entered in locator. 50. 58. Insured’s Name.

https://www.bluecrossma.com/staticcontent/npi_docs/UB_04FormLocatorAppendices.pdf
UB-04 Form Locator Appendices
Required for claims related to one of the following conditions: …. 58. Terminated
Medicare Advantage enrollee whose three day hospital stay was waived. 59 …. **
For Medicare, use this code only for reporting Part B co-insurance amounts.

http://www.hrsa.gov/ruralhealth/policy/confcall/rhccallarchive/rhcclaims5010.pdf
RHC claims issues and 5010 requirements – HRSA
claims can be sent directly to the Medicare payer. ✓ Many Practice … FL 18 – 28
= condition codes – rarely used … FL 58 – FL 62 = Required = Patient Insurance.

http://www.the-aaa.org/meetings_education/condition_codes/AAA%20Condition%20Code%20Audio%20Conference%20Slides.pdf
Condition Code Implementation
Intent of Condition Codes was that this one … No Longer Applicable to Medicare
… Condition Codes have been cross walked to “best fit” ICD9. Code ….. Page 58
 …

https://www.zolldata.com/uploadedFiles/ZOLL_Data_Management/Products/ImplementingConditionCodesinRescueNetBilling.pdf
Implementing Condition Codes in RescueNet Billing – Zoll
CMS released the medical conditions list on December 23, 2005 in Pub 100-04.
… these codes as defined in the CMS Medical Conditions List, as the ICD9 code.

http://www.valueoptions.com/providers/Forms/Administrative/Tips_for_Completing_the_UB04.pdf
Tips for Completing the UB04 (CMS-1450) Claim Form – ValueOptions
Mar 25, 2013 … Tips for Completing the UB04 (CMS-1450) Claim Form …. Conditional The
occurrence code and the … 58a, b, c Insured’s Name (last, first name …

http://www.ama-assn.org/resources/doc/cpt/icd9cm_coding_guidelines_08-09_sm.pdf
2009 ICD-9-CM – American Medical Association
The Centers for Medicare and Medicaid Services (CMS) …. H. ICD-9-CM code for
the diagnosis, condition, …… code V58.0, Encounter for radiation therapy,.

http://www.ngsmedicare.com/ngs/wcm/connect/6651c4804b71f3f6907c9dcada937a59/MMR+June+2012+BulletinFinal.pdf?MOD=AJPERES&CACHEID=6651c4804b71f3f6907c9dcada937a59
Medicare Monthly Review June 2012-06 Bulletin – National …
Jun 1, 2012 … Clarification on Submitting Claims When Condition Code 44 Criteria Have …
Clarification of Medicare Conditional Payment Policy and Billing Procedures for
… Level of Care. Certifications and Recertifications (MM7701). 58. S …

http://housedocs.house.gov/energycommerce/ppacacon.pdf
Compilation of Patient Protection and Affordable Care Act – House of …
Jun 9, 2010 … United States Code section numbers … a preexisting condition . ….. change and
State Medicaid, CHIP, and health subsidy programs ……….. 133.

http://www.sgo.org/wp-content/uploads/2012/09/Medicare-Global-Surgery-Modifiers.pdf
Medicare Global Surgery Modifiers – SGO
Append modifier 22 to the CPT code for the procedure performed. … technical
difficulty, severity of the patient’s condition, or physical … ICD-9-CM V58.1 may be
.

http://www.ime.state.ia.us/docs/UB04_BillingInstructions.pdf
Iowa Medicaid Enterprise UB-04 Claim Form Health Insurance …
or conditional of the individual recipient’s situation. … reported using value codes
in fields 39a-41d. … OPTIONAL Enter the zip code for the patient’s address. 9e …..
58. Insured’s name. REQUIRED. Enter the last name, first name, and middle.

http://www.utsystem.edu/compliance/SWCAcademy%20presentations/Materials/2013-03-27%20Medical%20Necessity%20and%20Short%20Stays.pdf
Surviving the Ongoing Focus on Medical Necessity and Short Stays
Mar 27, 2013 … The Medicare Administrative Contractors (MAC) via pre- pay reviews ….. When
Condition Code 44 is appropriately used, the hospital reports on.

http://www.aao.org/aaoe/coding/upload/covered-dx-for-eye-codes.pdf
Typical covered diagnosis codes
All Medicare LCDs for Eye codes contain a list of covered di- … conditions
classified elsewhere and ….. primary diagnosis code and V58.69 long-term cur-.

https://www.medicaid.state.ar.us/Download/provider/training/Billing101.pdf
Billing for 2013 – Arkansas Medicaid
Medicare and TRICARE) and recovers public health plan expenditures when
third-party ….. Plan Description 58, 78, 88. • Beneficiaries are not ….. Condition
Codes. *Inpatient paper claims must not use new condition codes 80, 81, or 82.

http://www.hscsn-net.org/training/CMS%201500_508.pdf
Completing a CMS 1500 Form – hscsn
In the office situation, all information required to complete the CMS form is found:
…. carriers use this box for approved condition codes that may be found on the.

http://manuals.momed.com/collections/collection_gen/General_Section01.pdf
General Section 1 – Participant Conditions of Participation
Section 1 – Client Conditions of Participation …. IDENTIFICATION OF P
ARTICIPANTS BY ELIGIBILITY CODES ………………………….. … Medicare Part A,
Part B and Part C .. ….. ME CODE. DESCRIPTION. 58. Pregnant women who
qualify under the.