| Code | Description | Deutsch (German) | Version |
| ... | No suggested values defined | keine Werte vorgeschlagen | added v2.5.1 |
| 01 | Military service related | | added v2.3.1, removed after v2.4 |
| 02 | Condition is employment related | | added v2.3.1, removed after v2.4 |
| 03 | Patient covered by insurance not reflected here | | added v2.3.1, removed after v2.4 |
| 04 | HMO enrollee | | added v2.3.1, removed after v2.4 |
| 05 | Lien has been filed | | added v2.3.1, removed after v2.4 |
| 06 | ESRD patient in first 18 months of entitlement covered by employer group health insurance | | added v2.3.1, removed after v2.4 |
| 07 | Treatment of non-terminal condition for hospice patient | | added v2.3.1, removed after v2.4 |
| 08 | Beneficiary would not provide information concerning other insurance coverage | | added v2.3.1, removed after v2.4 |
| 09 | Neither patient nor spouse is employed | | added v2.3.1, removed after v2.4 |
| 10 | Patient and/or spouse is employed but no EGHP exists | | added v2.3.1, removed after v2.4 |
| 11 | Disabled beneficiary but no LGHP | | added v2.3.1, removed after v2.4 |
| 12 | Payer codes. | | added v2.3.1, removed after v2.4 |
| 12 ... 16 | Payer codes. | | added v2.3.1, removed after v2.4 |
| 13 | Payer codes. | | added v2.3.1, removed after v2.4 |
| 14 | Payer codes. | | added v2.3.1, removed after v2.4 |
| 15 | Payer codes. | | added v2.3.1, removed after v2.4 |
| 16 | Payer codes. | | added v2.3.1, removed after v2.4 |
| 18 | Maiden name retained | | added v2.3.1, removed after v2.4 |
| 19 | Child retains mother's name | | added v2.3.1, removed after v2.4 |
| 20 | Beneficiary requested billing | | added v2.3.1, removed after v2.4 |
| 21 | Billing for Denial Notice | | added v2.3.1, removed after v2.4 |
| 26 | VA eligible patient chooses to receive services in a Medicare certified facility | | added v2.3.1, removed after v2.4 |
| 27 | Patient referred to a sole community hospital for a diagnostic laboratory test | | added v2.3.1, removed after v2.4 |
| 28 | Patient and/or spouse's EGHP is secondary to Medicare | | added v2.3.1, removed after v2.4 |
| 29 | Disabled beneficiary and/or family member's LGHP is secondary to Medicare | | added v2.3.1, removed after v2.4 |
| 31 | Patient is student (full time-day) | | added v2.3.1, removed after v2.4 |
| 32 | Patient is student (cooperative/work study program) | | added v2.3.1, removed after v2.4 |
| 33 | Patient is student (full time-night) | | added v2.3.1, removed after v2.4 |
| 34 | Patient is student (Part time) | | added v2.3.1, removed after v2.4 |
| 36 | General care patient in a special unit | | added v2.3.1, removed after v2.4 |
| 37 | Ward accommodation as patient request | | added v2.3.1, removed after v2.4 |
| 38 | Semi-private room not available | | added v2.3.1, removed after v2.4 |
| 39 | Private room medically necessary | | added v2.3.1, removed after v2.4 |
| 40 | Same day transfer | | added v2.3.1, removed after v2.4 |
| 41 | Partial hospitalization | | added v2.3.1, removed after v2.4 |
| 46 | Non-availability statement on file | | added v2.3.1, removed after v2.4 |
| 48 | Psychiatric residential treatment centers for children and adolescents | | added v2.3.1, removed after v2.4 |
| 55 | SNF bed not available | | added v2.3.1, removed after v2.4 |
| 56 | Medical appropriateness | | added v2.3.1, removed after v2.4 |
| 57 | SNF readmission | | added v2.3.1, removed after v2.4 |
| 60 | Day outlier | | added v2.3.1, removed after v2.4 |
| 61 | Cost outlier | | added v2.3.1, removed after v2.4 |
| 62 | Payer code | | added v2.3.1, removed after v2.4 |
| 66 | Provider does not wish cost outlier payment | | added v2.3.1, removed after v2.4 |
| 67 | Beneficiary elects not to use life time reserve (LTR) days | | added v2.3.1, removed after v2.4 |
| 68 | Beneficiary elects to use life time reserve (LTR) days | | added v2.3.1, removed after v2.4 |
| 70 | Self-administered EPO | | added v2.3.1, removed after v2.4 |
| 71 | Full care in unit | | added v2.3.1, removed after v2.4 |
| 72 | Self-care in unit | | added v2.3.1, removed after v2.4 |
| 73 | Self-care training | | added v2.3.1, removed after v2.4 |
| 74 | Home | | added v2.3.1, removed after v2.4 |
| 75 | Home - 100% reimbursement | | added v2.3.1, removed after v2.4 |
| 76 | Back-up in facility dialysis | | added v2.3.1, removed after v2.4 |
| 77 | Provider accepts or is obligated/required due to a contractual arrangement or law to accept payment by a primary payer as payment in full | | added v2.3.1, removed after v2.4 |
| 78 | New coverage not implemented by HMO | | added v2.3.1, removed after v2.4 |
| 79 | Corf services provided off-site | | added v2.3.1, removed after v2.4 |
| 80 | Pregnant | | added v2.3.1, removed after v2.4 |
. Page versions: R4 R3 R2
|
|
Propose a change