Occurrence Span Codes

X
 
Code Description
70 Qualifying Stay Dates - SNF TOB 3-day hospital stay qualifying stay dates for SNF use only.
70 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 Hospital 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 - 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.
74 Noncovered Level of Care - 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 - 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-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.
M0 QIO/UR 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 - 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 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
M5-MQ Reserved for National Assignment
MR Reserved for Disaster related code
MS-WZ Reserved for National Assignment
X0-ZZ Reserved for State Assignment. Discontinued, effective October 16, 2003.

 

Last Updated Wed, 26 Sep 2018 09:01:15 +0000