Occurrence Span Codes

 

Note: Any codes not listed within this table are not currently in use by CMS. This includes any code ranges that are considered Reserved for National Assignment.

Code Description Additional Detail
70 Qualifying stay dates for SNF use only SNF TOB 3-day hospital stay qualifying stay dates for SNF use only.
70 Qualifying stay dates for SNF use only Nonutilization Dates - PPS inlier (free days) stay for which the beneficiary has exhausted all regular days and/or coinsurance days, but which is covered on the cost report.
71 Prior stay dates (Part A Claims Only) From/Through dates given by the patient of any hospital stay that ended within 60 days of this hospital or SNF admission.
72 First/last visit dates This code and corresponding dates indicate the actual dates of the first and last outpatient services visit. Note: This code is used for outpatient bills only when the actual from and through service dates shown in FL 6, statement covers period, do not represent the entire billing record. The dates should reflect the first and last time the patient was seen or treated within the FL 6 billing period. Repetitive services and related services should be submitted to Medicare on one monthly bill. When providers bill the entire month, use occurrence span code 72 to reflect the first and last visit dates.
73 Benefit eligibility period  
74 Non-covered level of care/leave of absence dates From/through dates of a period at a non-covered level of care or leave of absence in an otherwise covered stay. Also used for Part B repetitive services to show a period of inpatient hospital care or outpatient surgery during the billing period.
75 SNF level of care dates From/through dates of a period at a non-covered level of care during an inpatient hospital stay - only used when SNF bed is not available.
76 Patient liability From/through dates of a period of non-covered care for which the hospital/ SNF is permitted to charge the Medicare beneficiary.
77 Provider liability period Utilization Charged - The from/through dates of a period of non-covered care for which the provider is liable.
78 SNF prior stay dates From/through dates given by the patient of any SNF or nursing home stay that ended within 60 days of this hospital/SNF admission.
79 Payer code This code is set aside for payer use only. Providers do not report this code.
80 Prior same-SNF stay dates for payment ban purposes  
81 Antepartum days at reduced level of care (effective 7/1/12)  
82 Hospital at Home Care Dates The from/through dates of a period of hospital at home care provided during an inpatient hospital stay.
M0 QIO/UR approved stay dates If a code "C3" is in FL 24-30, the provider enters the From and Through dates of the approved billing period.
M1 Provider liability - no utilization No utilization - code indicating From/Through dates of noncovered care denied for lack of medical necessity. Provider may not collect Part A or Part B deductible or coinsurance from the beneficiary.
M2 Inpatient Respite dates Dates of Inpatient Respite Care for hospice patients.
M3 ICF Level of care From/through dates of a period of intermediate level of care during an inpatient hospital stay.
M4 Residential level of care From/through dates of period of residential level of care during an inpatient stay.
MR Reserved for disaster related occurrence span code  
Z0-ZZ Payer Code  

 

Last Updated Dec 09 , 2023