Medical Billing Forum

Billing => Billing => : tperian February 11, 2020, 11:30:55 AM

: RHC UB 4 Claims help
: tperian February 11, 2020, 11:30:55 AM

We are a Rural Health Clinic trying to bill Humana Medicare for CCM.  We just started having anissue where the calims are denying for " admission type and patient status codes needed".   Since we are a clinic and not a hospital, i have no clue what would go where.  Or even i this denial is correct.  Any help? 

: Re: RHC UB 4 Claims help
: Michele February 12, 2020, 09:38:25 AM

Admission type is box 14.  There are only 6 options:

1 Emergency
2 urgent
3 elective
4 newborn
5 trauma center
9 information not available

Patient status codes are box 17.  There are over 20 options for that.  CCM has a couple different meanings so I'm not 100% sure what services you are providing, but some of the common ones are:
01  discharged to home or self care (routine discharge)
20  Expired
30  still a patient

Hope that helps!