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900 lines
169 KiB
900 lines
169 KiB
<?php |
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$ub04_codes = array( |
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array('id' => '1','code_group' => 'revenue_code','code' => '0001','desc' => 'Total Charge','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '2','code_group' => 'revenue_code','code' => '0022','desc' => 'HIPPS','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '3','code_group' => 'revenue_code','code' => '0023','desc' => 'HIPPS','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '4','code_group' => 'revenue_code','code' => '0024','desc' => 'HIPPS','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '5','code_group' => 'revenue_code','code' => '0100','desc' => 'All Inclusive Rate','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '6','code_group' => 'revenue_code','code' => '0101','desc' => 'All Inclusive Rate','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '7','code_group' => 'revenue_code','code' => '0110','desc' => 'Room & Board (Private)','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '8','code_group' => 'revenue_code','code' => '0111','desc' => 'Medical/Surgical/Gyn','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '9','code_group' => 'revenue_code','code' => '0112','desc' => 'OB','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '10','code_group' => 'revenue_code','code' => '0113','desc' => 'Pediatric','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '11','code_group' => 'revenue_code','code' => '0114','desc' => 'Psychiatric','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '12','code_group' => 'revenue_code','code' => '0115','desc' => 'Hospice','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '13','code_group' => 'revenue_code','code' => '0116','desc' => 'Detoxification','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '14','code_group' => 'revenue_code','code' => '0117','desc' => 'Oncology','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '15','code_group' => 'revenue_code','code' => '0118','desc' => 'Rehab','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '16','code_group' => 'revenue_code','code' => '0119','desc' => 'Other','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '17','code_group' => 'revenue_code','code' => '0120','desc' => 'Room & Board (Semi-Private 2 beds)','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '18','code_group' => 'revenue_code','code' => '0121','desc' => 'Medical/Surgical/Gyn','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '19','code_group' => 'revenue_code','code' => '0122','desc' => 'OB','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '20','code_group' => 'revenue_code','code' => '0123','desc' => 'Pediatric','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '21','code_group' => 'revenue_code','code' => '0124','desc' => 'Psychiatric','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '22','code_group' => 'revenue_code','code' => '0125','desc' => 'Hospice','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '23','code_group' => 'revenue_code','code' => '0126','desc' => 'Detoxification','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '24','code_group' => 'revenue_code','code' => '0127','desc' => 'Oncology','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '25','code_group' => 'revenue_code','code' => '0128','desc' => 'Rehab','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '26','code_group' => 'revenue_code','code' => '0129','desc' => 'Other','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '27','code_group' => 'revenue_code','code' => '0130','desc' => 'Room&Board (Semi private 3-4 beds)','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '28','code_group' => 'revenue_code','code' => '0131','desc' => 'Medical/Surgical/Gyn','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '29','code_group' => 'revenue_code','code' => '0132','desc' => 'OB','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '30','code_group' => 'revenue_code','code' => '0133','desc' => 'Pediatric','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '31','code_group' => 'revenue_code','code' => '0134','desc' => 'Psychiatric','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '32','code_group' => 'revenue_code','code' => '0135','desc' => 'Hospice','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '33','code_group' => 'revenue_code','code' => '0136','desc' => 'Detoxification','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '34','code_group' => 'revenue_code','code' => '0137','desc' => 'Oncology','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '35','code_group' => 'revenue_code','code' => '0138','desc' => 'Rehab','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '36','code_group' => 'revenue_code','code' => '0139','desc' => 'Other','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '37','code_group' => 'revenue_code','code' => '0140','desc' => 'Room & Board (Private Deluxe)','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '38','code_group' => 'revenue_code','code' => '0141','desc' => 'Medical/Surgical/Gyn','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '39','code_group' => 'revenue_code','code' => '0142','desc' => 'OB','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '40','code_group' => 'revenue_code','code' => '0143','desc' => 'Pediatric','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '41','code_group' => 'revenue_code','code' => '0144','desc' => 'Psychiatric','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '42','code_group' => 'revenue_code','code' => '0145','desc' => 'Hospice','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '43','code_group' => 'revenue_code','code' => '0146','desc' => 'Detoxification','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '44','code_group' => 'revenue_code','code' => '0147','desc' => 'Oncology','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '45','code_group' => 'revenue_code','code' => '0148','desc' => 'Rehab','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '46','code_group' => 'revenue_code','code' => '0149','desc' => 'Other','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '47','code_group' => 'revenue_code','code' => '0150','desc' => 'Room & Board (Ward)','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '48','code_group' => 'revenue_code','code' => '0151','desc' => 'Medical/Surgical/Gyn','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '49','code_group' => 'revenue_code','code' => '0152','desc' => 'OB','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '50','code_group' => 'revenue_code','code' => '0153','desc' => 'Pediatric','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '51','code_group' => 'revenue_code','code' => '0154','desc' => 'Psychiatric','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '52','code_group' => 'revenue_code','code' => '0155','desc' => 'Hospice','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '53','code_group' => 'revenue_code','code' => '0156','desc' => 'Detoxification','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '54','code_group' => 'revenue_code','code' => '0157','desc' => 'Oncology','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '55','code_group' => 'revenue_code','code' => '0158','desc' => 'Rehab','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '56','code_group' => 'revenue_code','code' => '0159','desc' => 'Other','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '57','code_group' => 'revenue_code','code' => '0160','desc' => 'Room & Board (other)','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '58','code_group' => 'revenue_code','code' => '0164','desc' => 'Sterile Environment','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '59','code_group' => 'revenue_code','code' => '0167','desc' => 'Self care','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '60','code_group' => 'revenue_code','code' => '0169','desc' => 'Other','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '61','code_group' => 'revenue_code','code' => '0170','desc' => 'Nursery','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '62','code_group' => 'revenue_code','code' => '0171','desc' => 'Newborn-Level I','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '63','code_group' => 'revenue_code','code' => '0172','desc' => 'Newborn-Level II','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '64','code_group' => 'revenue_code','code' => '0173','desc' => 'Newborn-Level III','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '65','code_group' => 'revenue_code','code' => '0174','desc' => 'Newborn-Level IV','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '66','code_group' => 'revenue_code','code' => '0179','desc' => 'Other Nursery','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '67','code_group' => 'revenue_code','code' => '0180','desc' => 'Leave of Absence','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '68','code_group' => 'revenue_code','code' => '0182','desc' => 'Patient Convenience','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '69','code_group' => 'revenue_code','code' => '0183','desc' => 'Therapeutic Leave','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '70','code_group' => 'revenue_code','code' => '0185','desc' => 'Hospitalization','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '71','code_group' => 'revenue_code','code' => '0189','desc' => 'Other leave of absence','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '72','code_group' => 'revenue_code','code' => '0190','desc' => 'Subacute care','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '73','code_group' => 'revenue_code','code' => '0191','desc' => 'Subacute care-Level I','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '74','code_group' => 'revenue_code','code' => '0192','desc' => 'Subacute care-Level II','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '75','code_group' => 'revenue_code','code' => '0193','desc' => 'Subacute care-Level III','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '76','code_group' => 'revenue_code','code' => '0194','desc' => 'Subacute care-Level IV','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '77','code_group' => 'revenue_code','code' => '0199','desc' => 'Other subacute care','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '78','code_group' => 'revenue_code','code' => '0200','desc' => 'Intensive care','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '79','code_group' => 'revenue_code','code' => '0201','desc' => 'Surgical','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '80','code_group' => 'revenue_code','code' => '0202','desc' => 'Medical','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '81','code_group' => 'revenue_code','code' => '0203','desc' => 'Pediatric','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '82','code_group' => 'revenue_code','code' => '0204','desc' => 'Psychiatric','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '83','code_group' => 'revenue_code','code' => '0206','desc' => 'Intermediate ICU','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '84','code_group' => 'revenue_code','code' => '0207','desc' => 'Burn care','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '85','code_group' => 'revenue_code','code' => '0208','desc' => 'Trauma','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '86','code_group' => 'revenue_code','code' => '0209','desc' => 'Other intensive care','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '87','code_group' => 'revenue_code','code' => '0210','desc' => 'Coronary care','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '88','code_group' => 'revenue_code','code' => '0211','desc' => 'Myocardial Infarction','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '89','code_group' => 'revenue_code','code' => '0212','desc' => 'Pulmonary Care','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '90','code_group' => 'revenue_code','code' => '0213','desc' => 'Heart Transplant','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '91','code_group' => 'revenue_code','code' => '0214','desc' => 'Intermediate CCU','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '92','code_group' => 'revenue_code','code' => '0219','desc' => 'Other Coronary Care','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '93','code_group' => 'revenue_code','code' => '0220','desc' => 'Special charges','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '94','code_group' => 'revenue_code','code' => '0221','desc' => 'Admission charge','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '95','code_group' => 'revenue_code','code' => '0222','desc' => 'Technical support charge','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '96','code_group' => 'revenue_code','code' => '0223','desc' => 'U.R. service charge','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '97','code_group' => 'revenue_code','code' => '0224','desc' => 'Late discharge, medically necessary','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '98','code_group' => 'revenue_code','code' => '0229','desc' => 'Other special charges','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '99','code_group' => 'revenue_code','code' => '0230','desc' => 'Incremental nursing charge rate','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '100','code_group' => 'revenue_code','code' => '0231','desc' => 'Nursery','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '101','code_group' => 'revenue_code','code' => '0232','desc' => 'OB','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '102','code_group' => 'revenue_code','code' => '0233','desc' => 'ICU','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '103','code_group' => 'revenue_code','code' => '0234','desc' => 'CCU','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '104','code_group' => 'revenue_code','code' => '0235','desc' => 'Hospice','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '105','code_group' => 'revenue_code','code' => '0239','desc' => 'Other','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '106','code_group' => 'revenue_code','code' => '0240','desc' => 'All inclusive Ancillary','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '107','code_group' => 'revenue_code','code' => '0241','desc' => 'Basic','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '108','code_group' => 'revenue_code','code' => '0242','desc' => 'Comprehensive','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '109','code_group' => 'revenue_code','code' => '0243','desc' => 'Specialty','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '110','code_group' => 'revenue_code','code' => '0249','desc' => 'Other all inclusive ancillary','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '111','code_group' => 'revenue_code','code' => '0250','desc' => 'Pharmacy','desc1' => 'Drugs Charged to Patients','desc2' => '','desc3' => ''), |
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array('id' => '112','code_group' => 'revenue_code','code' => '0251','desc' => 'Pharmacy: Generic','desc1' => 'Drugs Charged to Patients','desc2' => '','desc3' => ''), |
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array('id' => '113','code_group' => 'revenue_code','code' => '0252','desc' => 'Pharmacy: Nongeneric','desc1' => 'Drugs Charged to Patients','desc2' => '','desc3' => ''), |
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array('id' => '114','code_group' => 'revenue_code','code' => '0253','desc' => 'Take home drugs','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '115','code_group' => 'revenue_code','code' => '0254','desc' => 'Pharmacy: Incident to other diagnostic services','desc1' => 'Drugs Charged to Patients','desc2' => '','desc3' => ''), |
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array('id' => '116','code_group' => 'revenue_code','code' => '0255','desc' => 'Pharmacy: Incident to radiology','desc1' => 'Drugs Charged to Patients','desc2' => '','desc3' => ''), |
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array('id' => '117','code_group' => 'revenue_code','code' => '0256','desc' => 'Pharmacy: Experimental drugs','desc1' => 'Drugs Charged to Patients','desc2' => '','desc3' => ''), |
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array('id' => '118','code_group' => 'revenue_code','code' => '0257','desc' => 'Pharmacy: Non-prescription','desc1' => 'Drugs Charged to Patients','desc2' => '','desc3' => ''), |
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array('id' => '119','code_group' => 'revenue_code','code' => '0258','desc' => 'Pharmacy: IV solutions','desc1' => 'Drugs Charged to Patients','desc2' => '','desc3' => ''), |
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array('id' => '120','code_group' => 'revenue_code','code' => '0259','desc' => 'Pharmacy: Other','desc1' => 'Drugs Charged to Patients','desc2' => '','desc3' => ''), |
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array('id' => '121','code_group' => 'revenue_code','code' => '0260','desc' => 'IV Therapy','desc1' => 'Intravenous Therapy','desc2' => '','desc3' => ''), |
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array('id' => '122','code_group' => 'revenue_code','code' => '0261','desc' => 'IV Therapy: Infusion pump','desc1' => 'Intravenous Therapy','desc2' => '','desc3' => ''), |
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array('id' => '123','code_group' => 'revenue_code','code' => '0262','desc' => 'IV Therapy: IV Therapy, pharm services','desc1' => 'Intravenous Therapy','desc2' => '','desc3' => ''), |
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array('id' => '124','code_group' => 'revenue_code','code' => '0263','desc' => 'IV Therapy: IV Therapy/drug/supp/delivery','desc1' => 'Intravenous Therapy','desc2' => '','desc3' => ''), |
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array('id' => '125','code_group' => 'revenue_code','code' => '0264','desc' => 'IV Therapy: supplies','desc1' => 'Intravenous Therapy','desc2' => '','desc3' => ''), |
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array('id' => '126','code_group' => 'revenue_code','code' => '0269','desc' => 'IV Therapy: Other IV therapy','desc1' => 'Intravenous Therapy','desc2' => '','desc3' => ''), |
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array('id' => '127','code_group' => 'revenue_code','code' => '0270','desc' => 'Medical/Surgical Supplies','desc1' => 'Medical Supplies Charged to Patients','desc2' => '','desc3' => ''), |
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array('id' => '128','code_group' => 'revenue_code','code' => '0271','desc' => 'Medical/Surgical Supplies: Nonsterile supplies','desc1' => 'Medical Supplies Charged to Patients','desc2' => '','desc3' => ''), |
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array('id' => '129','code_group' => 'revenue_code','code' => '0272','desc' => 'Medical/Surgical Supplies: Sterile supplies','desc1' => 'Medical Supplies Charged to Patients','desc2' => '','desc3' => ''), |
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array('id' => '130','code_group' => 'revenue_code','code' => '0273','desc' => 'Medical/Surgical Supplies: Take home supplies','desc1' => 'Medical Supplies Charged to Patients','desc2' => '','desc3' => ''), |
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array('id' => '131','code_group' => 'revenue_code','code' => '0274','desc' => 'Medical/Surgical Supplies: Prosthetic/Orthotic devices','desc1' => 'Prosthetic Devices','desc2' => 'Medical Supplies Charged to Patients','desc3' => ''), |
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array('id' => '132','code_group' => 'revenue_code','code' => '0275','desc' => 'Medical/Surgical Supplies: Pacemaker','desc1' => 'Impl. Dev. Charged to Patient','desc2' => 'Prosthetic Devices','desc3' => 'Medical Supplies Charged to Patients'), |
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array('id' => '133','code_group' => 'revenue_code','code' => '0276','desc' => 'Medical/Surgical Supplies: Intraocular lens','desc1' => 'Impl. Dev. Charged to Patient','desc2' => 'Prosthetic Devices','desc3' => 'Medical Supplies Charged to Patients'), |
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array('id' => '134','code_group' => 'revenue_code','code' => '0277','desc' => 'Oxygen-Take home','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '135','code_group' => 'revenue_code','code' => '0278','desc' => 'Medical/Surgical Supplies: Other implants','desc1' => 'Impl. Dev. Charged to Patient','desc2' => 'Medical Supplies Charged to Patients','desc3' => ''), |
|
array('id' => '136','code_group' => 'revenue_code','code' => '0279','desc' => 'Medical/Surgical Supplies: Other supplies/devices','desc1' => 'Medical Supplies Charged to Patients','desc2' => '','desc3' => ''), |
|
array('id' => '137','code_group' => 'revenue_code','code' => '0280','desc' => 'Oncology','desc1' => 'Oncology','desc2' => '','desc3' => ''), |
|
array('id' => '138','code_group' => 'revenue_code','code' => '0289','desc' => 'Oncology: Other oncology','desc1' => 'Oncology','desc2' => '','desc3' => ''), |
|
array('id' => '139','code_group' => 'revenue_code','code' => '0290','desc' => 'Durable Medical Equipment','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '140','code_group' => 'revenue_code','code' => '0291','desc' => 'DME Rental','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '141','code_group' => 'revenue_code','code' => '0292','desc' => 'Durable Medical Equipment: Purchase - new equipment','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '142','code_group' => 'revenue_code','code' => '0293','desc' => 'Purchase of used DME','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '143','code_group' => 'revenue_code','code' => '0294','desc' => 'Supplies/Drugs for DME effectiveness (HHA only)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '144','code_group' => 'revenue_code','code' => '0299','desc' => 'Durable Medical Equipment: Other equipment','desc1' => 'Durable Medical Equip. - Sold','desc2' => 'Medical Supplies Charged to Patients','desc3' => ''), |
|
array('id' => '145','code_group' => 'revenue_code','code' => '0300','desc' => 'Laboratory - Clinical Diagnostic','desc1' => 'Laboratory - Clinical','desc2' => '','desc3' => ''), |
|
array('id' => '146','code_group' => 'revenue_code','code' => '0301','desc' => 'Laboratory - Clinical Diagnostic: Chemistry','desc1' => 'Chemistry','desc2' => 'Laboratory - Clinical','desc3' => 'Laboratory'), |
|
array('id' => '147','code_group' => 'revenue_code','code' => '0302','desc' => 'Laboratory - Clinical Diagnostic: Immunology','desc1' => 'Immunology','desc2' => 'Laboratory - Clinical','desc3' => 'Laboratory'), |
|
array('id' => '148','code_group' => 'revenue_code','code' => '0303','desc' => 'Laboratory - Clinical Diagnostic: Renal patient (home)','desc1' => 'Laboratory - Clinical','desc2' => 'Laboratory','desc3' => ''), |
|
array('id' => '149','code_group' => 'revenue_code','code' => '0304','desc' => 'Laboratory - Clinical Diagnostic: Nonroutine dialysis','desc1' => 'Laboratory - Clinical','desc2' => 'Laboratory','desc3' => ''), |
|
array('id' => '150','code_group' => 'revenue_code','code' => '0305','desc' => 'Laboratory - Clinical Diagnostic: Hematology','desc1' => 'Hematology','desc2' => 'Laboratory - Clinical','desc3' => 'Laboratory'), |
|
array('id' => '151','code_group' => 'revenue_code','code' => '0306','desc' => 'Laboratory - Clinical Diagnostic: Bacteriology/microbiology','desc1' => 'Bacteriology & Microbiology','desc2' => 'Laboratory - Clinical','desc3' => 'Laboratory'), |
|
array('id' => '152','code_group' => 'revenue_code','code' => '0307','desc' => 'Laboratory - Clinical Diagnostic: Urology','desc1' => 'Laboratory - Clinical','desc2' => 'Laboratory','desc3' => ''), |
|
array('id' => '153','code_group' => 'revenue_code','code' => '0309','desc' => 'Laboratory - Clinical Diagnostic: Other laboratory','desc1' => 'Laboratory - Clinical','desc2' => 'Laboratory','desc3' => ''), |
|
array('id' => '154','code_group' => 'revenue_code','code' => '0310','desc' => 'Laboratory - Pathology','desc1' => 'Laboratory - Pathological','desc2' => 'Laboratory','desc3' => ''), |
|
array('id' => '155','code_group' => 'revenue_code','code' => '0311','desc' => 'Laboratory - Pathology: Cytology','desc1' => 'Cytology','desc2' => 'Laboratory - Pathological','desc3' => 'Laboratory'), |
|
array('id' => '156','code_group' => 'revenue_code','code' => '0312','desc' => 'Laboratory - Pathology: Histology','desc1' => 'Histology','desc2' => 'Laboratory - Pathological','desc3' => 'Laboratory'), |
|
array('id' => '157','code_group' => 'revenue_code','code' => '0314','desc' => 'Laboratory - Pathology: Biopsy','desc1' => 'Biopsy','desc2' => 'Laboratory - Pathological','desc3' => 'Laboratory'), |
|
array('id' => '158','code_group' => 'revenue_code','code' => '0319','desc' => 'Laboratory - Pathology: Other','desc1' => 'Laboratory - Pathological','desc2' => 'Laboratory','desc3' => ''), |
|
array('id' => '159','code_group' => 'revenue_code','code' => '0320','desc' => 'Radiology - Diagnostic','desc1' => 'Radiology - Diagnostic','desc2' => '','desc3' => ''), |
|
array('id' => '160','code_group' => 'revenue_code','code' => '0321','desc' => 'Radiology - Diagnostic: Angiocardiography','desc1' => 'Angiocardiography','desc2' => 'Cardiac Catheterization','desc3' => 'Cardiology'), |
|
array('id' => '161','code_group' => 'revenue_code','code' => '0322','desc' => 'Radiology - Diagnostic: Arthrography','desc1' => 'Radiology - Diagnostic','desc2' => '','desc3' => ''), |
|
array('id' => '162','code_group' => 'revenue_code','code' => '0323','desc' => 'Radiology - Diagnostic: Arteriography','desc1' => 'Vascular Lab','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '163','code_group' => 'revenue_code','code' => '0324','desc' => 'Radiology - Diagnostic: Chest X-ray','desc1' => 'Radiology - Diagnostic','desc2' => '','desc3' => ''), |
|
array('id' => '164','code_group' => 'revenue_code','code' => '0329','desc' => 'Radiology - Diagnostic: Other','desc1' => 'Radiology - Diagnostic','desc2' => '','desc3' => ''), |
|
array('id' => '165','code_group' => 'revenue_code','code' => '0330','desc' => 'Radiology - Therapeutic','desc1' => 'Radiology - Therapeutic','desc2' => '','desc3' => ''), |
|
array('id' => '166','code_group' => 'revenue_code','code' => '0331','desc' => 'Radiology - Therapeutic: Chemotherapy - injected','desc1' => 'Chemotherapy','desc2' => 'Oncology','desc3' => ''), |
|
array('id' => '167','code_group' => 'revenue_code','code' => '0332','desc' => 'Radiology - Therapeutic: Chemotherapy - oral','desc1' => 'Chemotherapy','desc2' => 'Oncology','desc3' => ''), |
|
array('id' => '168','code_group' => 'revenue_code','code' => '0333','desc' => 'Radiology - Therapeutic: Radiation therapy','desc1' => 'Radiology - Therapeutic','desc2' => '','desc3' => ''), |
|
array('id' => '169','code_group' => 'revenue_code','code' => '0335','desc' => 'Radiology - Therapeutic: Chemotherapy - IV','desc1' => 'Chemotherapy','desc2' => 'Radiology - Therapeutic','desc3' => ''), |
|
array('id' => '170','code_group' => 'revenue_code','code' => '0339','desc' => 'Radiology - Therapeutic: Other','desc1' => 'Radiology - Therapeutic','desc2' => '','desc3' => ''), |
|
array('id' => '171','code_group' => 'revenue_code','code' => '0340','desc' => 'Nuclear Medicine','desc1' => 'Nuclear Medicine - Diagnostic','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '172','code_group' => 'revenue_code','code' => '0341','desc' => 'Nuclear Medicine: Diagnostic','desc1' => 'Nuclear Medicine - Diagnostic','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '173','code_group' => 'revenue_code','code' => '0342','desc' => 'Nuclear Medicine: Therapeutic','desc1' => 'Nuclear Medicine - Therapeutic','desc2' => 'Radiology - Therapeutic','desc3' => ''), |
|
array('id' => '174','code_group' => 'revenue_code','code' => '0343','desc' => 'Diagnostic Radiopharms','desc1' => 'Nuclear Medicine - Diagnostic','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '175','code_group' => 'revenue_code','code' => '0344','desc' => 'Therapeutic Radiopharms','desc1' => 'Nuclear Medicine - Therapeutic','desc2' => 'Radiology - Therapeutic','desc3' => ''), |
|
array('id' => '176','code_group' => 'revenue_code','code' => '0349','desc' => 'Nuclear Medicine: Other','desc1' => 'Nuclear Medicine - Diagnostic','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '177','code_group' => 'revenue_code','code' => '0350','desc' => 'CT Scan','desc1' => 'CT Scan','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '178','code_group' => 'revenue_code','code' => '0351','desc' => 'CT Scan: Head','desc1' => 'CT Scan','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '179','code_group' => 'revenue_code','code' => '0352','desc' => 'CT Scan: Body','desc1' => 'CT Scan','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '180','code_group' => 'revenue_code','code' => '0359','desc' => 'CT Scan: Other CT scans','desc1' => 'CT Scan','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '181','code_group' => 'revenue_code','code' => '0360','desc' => 'Operating Room Services','desc1' => 'Operating Room','desc2' => '','desc3' => ''), |
|
array('id' => '182','code_group' => 'revenue_code','code' => '0361','desc' => 'Operating Room Services: Minor surgery','desc1' => 'Operating Room','desc2' => '','desc3' => ''), |
|
array('id' => '183','code_group' => 'revenue_code','code' => '0362','desc' => 'Operating Room Services: Organ trnsplnt, not kidney','desc1' => 'Operating Room','desc2' => '','desc3' => ''), |
|
array('id' => '184','code_group' => 'revenue_code','code' => '0367','desc' => 'Operating Room Services: Kidney transplant','desc1' => 'Operating Room','desc2' => '','desc3' => ''), |
|
array('id' => '185','code_group' => 'revenue_code','code' => '0369','desc' => 'Operating Room Services: Other operating room services','desc1' => 'Operating Room','desc2' => '','desc3' => ''), |
|
array('id' => '186','code_group' => 'revenue_code','code' => '0370','desc' => 'Anesthesia','desc1' => 'Anesthesiology','desc2' => '','desc3' => ''), |
|
array('id' => '187','code_group' => 'revenue_code','code' => '0371','desc' => 'Anesthesia: Incident to radiology','desc1' => 'Anesthesiology','desc2' => 'Radiology - Therapeutic','desc3' => ''), |
|
array('id' => '188','code_group' => 'revenue_code','code' => '0372','desc' => 'Anesthesia: Incident to other diag services','desc1' => 'Anesthesiology','desc2' => '','desc3' => ''), |
|
array('id' => '189','code_group' => 'revenue_code','code' => '0374','desc' => 'Acupuncture','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '190','code_group' => 'revenue_code','code' => '0379','desc' => 'Anesthesia: Other anesthesia','desc1' => 'Anesthesiology','desc2' => '','desc3' => ''), |
|
array('id' => '191','code_group' => 'revenue_code','code' => '0380','desc' => 'Blood','desc1' => 'Whole Blood & Packed Red Blood Cells','desc2' => '','desc3' => ''), |
|
array('id' => '192','code_group' => 'revenue_code','code' => '0381','desc' => 'Blood: Packed red cells','desc1' => 'Whole Blood & Packed Red Blood Cells','desc2' => '','desc3' => ''), |
|
array('id' => '193','code_group' => 'revenue_code','code' => '0382','desc' => 'Blood: Whole blood','desc1' => 'Whole Blood & Packed Red Blood Cells','desc2' => '','desc3' => ''), |
|
array('id' => '194','code_group' => 'revenue_code','code' => '0383','desc' => 'Blood: Plasma','desc1' => 'Whole Blood & Packed Red Blood Cells','desc2' => '','desc3' => ''), |
|
array('id' => '195','code_group' => 'revenue_code','code' => '0384','desc' => 'Blood: Platelets','desc1' => 'Whole Blood & Packed Red Blood Cells','desc2' => '','desc3' => ''), |
|
array('id' => '196','code_group' => 'revenue_code','code' => '0385','desc' => 'Blood: Leukocytes','desc1' => 'Whole Blood & Packed Red Blood Cells','desc2' => '','desc3' => ''), |
|
array('id' => '197','code_group' => 'revenue_code','code' => '0386','desc' => 'Blood: Other components','desc1' => 'Whole Blood & Packed Red Blood Cells','desc2' => '','desc3' => ''), |
|
array('id' => '198','code_group' => 'revenue_code','code' => '0387','desc' => 'Blood: Other derivatives','desc1' => 'Whole Blood & Packed Red Blood Cells','desc2' => '','desc3' => ''), |
|
array('id' => '199','code_group' => 'revenue_code','code' => '0389','desc' => 'Blood: Other blood','desc1' => 'Whole Blood & Packed Red Blood Cells','desc2' => '','desc3' => ''), |
|
array('id' => '200','code_group' => 'revenue_code','code' => '0390','desc' => 'Blood Storage/Processing','desc1' => 'Blood Storing, Processing, & Trans.','desc2' => '','desc3' => ''), |
|
array('id' => '201','code_group' => 'revenue_code','code' => '0391','desc' => 'Blood: - Administration (e.g. Transfusion)','desc1' => 'Blood Storing, Processing, & Trans.','desc2' => '','desc3' => ''), |
|
array('id' => '202','code_group' => 'revenue_code','code' => '0392','desc' => 'Blood: Processing and Storage','desc1' => 'Blood Storing, Processing, & Trans.','desc2' => '','desc3' => ''), |
|
array('id' => '203','code_group' => 'revenue_code','code' => '0399','desc' => 'Other blood handling','desc1' => 'Blood Storing, Processing, & Trans.','desc2' => '','desc3' => ''), |
|
array('id' => '204','code_group' => 'revenue_code','code' => '0400','desc' => 'Other Imaging Services','desc1' => 'Radiology - Diagnostic','desc2' => '','desc3' => ''), |
|
array('id' => '205','code_group' => 'revenue_code','code' => '0401','desc' => 'Other Imaging Services: Diagnostic mammography','desc1' => 'Mammography','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '206','code_group' => 'revenue_code','code' => '0402','desc' => 'Other Imaging Services: Ultrasound','desc1' => 'Ultra Sound','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '207','code_group' => 'revenue_code','code' => '0403','desc' => 'Other Imaging Services: Screening mammography','desc1' => 'Mammography','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '208','code_group' => 'revenue_code','code' => '0404','desc' => 'Other Imaging Services: PET scan','desc1' => 'Nuclear Medicine - Diagnostic','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '209','code_group' => 'revenue_code','code' => '0409','desc' => 'Other Imaging Services: Other imaging services','desc1' => 'Radiology - Diagnostic','desc2' => '','desc3' => ''), |
|
array('id' => '210','code_group' => 'revenue_code','code' => '0410','desc' => 'Respiratory Services','desc1' => 'Respiratory Therapy','desc2' => '','desc3' => ''), |
|
array('id' => '211','code_group' => 'revenue_code','code' => '0412','desc' => 'Respiratory Services: Inhalation services','desc1' => 'Respiratory Therapy','desc2' => '','desc3' => ''), |
|
array('id' => '212','code_group' => 'revenue_code','code' => '0413','desc' => 'Respiratory Services: Hyberbaric oxygen therapy','desc1' => 'Respiratory Therapy','desc2' => 'Respiratory Therapy','desc3' => ''), |
|
array('id' => '213','code_group' => 'revenue_code','code' => '0419','desc' => 'Respiratory Services: Other respiratory services','desc1' => 'Respiratory Therapy','desc2' => '','desc3' => ''), |
|
array('id' => '214','code_group' => 'revenue_code','code' => '0420','desc' => 'Physical Therapy','desc1' => 'Physical Therapy','desc2' => '','desc3' => ''), |
|
array('id' => '215','code_group' => 'revenue_code','code' => '0421','desc' => 'Physical Therapy: Visit charge','desc1' => 'Physical Therapy','desc2' => '','desc3' => ''), |
|
array('id' => '216','code_group' => 'revenue_code','code' => '0422','desc' => 'Physical Therapy: Hourly charge','desc1' => 'Physical Therapy','desc2' => '','desc3' => ''), |
|
array('id' => '217','code_group' => 'revenue_code','code' => '0423','desc' => 'Physical Therapy: Group rate','desc1' => 'Physical Therapy','desc2' => '','desc3' => ''), |
|
array('id' => '218','code_group' => 'revenue_code','code' => '0424','desc' => 'Physical Therapy: Evaluation/re-evaluation','desc1' => 'Physical Therapy','desc2' => '','desc3' => ''), |
|
array('id' => '219','code_group' => 'revenue_code','code' => '0429','desc' => 'Physical Therapy: Other physical therapy','desc1' => 'Physical Therapy','desc2' => '','desc3' => ''), |
|
array('id' => '220','code_group' => 'revenue_code','code' => '0430','desc' => 'Occupational Therapy','desc1' => 'Occupational Therapy','desc2' => '','desc3' => ''), |
|
array('id' => '221','code_group' => 'revenue_code','code' => '0431','desc' => 'Occupational Therapy: Visit charge','desc1' => 'Occupational Therapy','desc2' => '','desc3' => ''), |
|
array('id' => '222','code_group' => 'revenue_code','code' => '0432','desc' => 'Occupational Therapy: Hourly charge','desc1' => 'Occupational Therapy','desc2' => '','desc3' => ''), |
|
array('id' => '223','code_group' => 'revenue_code','code' => '0433','desc' => 'Occupational Therapy: Group rate','desc1' => 'Occupational Therapy','desc2' => '','desc3' => ''), |
|
array('id' => '224','code_group' => 'revenue_code','code' => '0434','desc' => 'Occupational Therapy: Evaluation/re-evaluation','desc1' => 'Occupational Therapy','desc2' => '','desc3' => ''), |
|
array('id' => '225','code_group' => 'revenue_code','code' => '0439','desc' => 'Occupational Therapy: Other occupational therapy','desc1' => 'Occupational Therapy','desc2' => '','desc3' => ''), |
|
array('id' => '226','code_group' => 'revenue_code','code' => '0440','desc' => 'Speech-Language Pathology','desc1' => 'Speech Pathology','desc2' => '','desc3' => ''), |
|
array('id' => '227','code_group' => 'revenue_code','code' => '0441','desc' => 'Speech-Language Pathology: Visit charge','desc1' => 'Speech Pathology','desc2' => '','desc3' => ''), |
|
array('id' => '228','code_group' => 'revenue_code','code' => '0442','desc' => 'Speech-Language Pathology: Hourly charge','desc1' => 'Speech Pathology','desc2' => '','desc3' => ''), |
|
array('id' => '229','code_group' => 'revenue_code','code' => '0443','desc' => 'Speech-Language Pathology: Group rate','desc1' => 'Speech Pathology','desc2' => '','desc3' => ''), |
|
array('id' => '230','code_group' => 'revenue_code','code' => '0444','desc' => 'Speech-Language Pathology: Evaluation/ re-evaluation','desc1' => 'Speech Pathology','desc2' => '','desc3' => ''), |
|
array('id' => '231','code_group' => 'revenue_code','code' => '0449','desc' => 'Speech-Language Pathology: Other speech language pathology','desc1' => 'Speech Pathology','desc2' => '','desc3' => ''), |
|
array('id' => '232','code_group' => 'revenue_code','code' => '0450','desc' => 'Emergency Room','desc1' => 'Emergency','desc2' => '','desc3' => ''), |
|
array('id' => '233','code_group' => 'revenue_code','code' => '0451','desc' => 'Emergency Room: EM/EMTALA','desc1' => 'Emergency','desc2' => '','desc3' => ''), |
|
array('id' => '234','code_group' => 'revenue_code','code' => '0452','desc' => 'Emergency Room: ER/ Beyond EMTALA','desc1' => 'Emergency','desc2' => '','desc3' => ''), |
|
array('id' => '235','code_group' => 'revenue_code','code' => '0456','desc' => 'Emergency Room: Urgent care','desc1' => 'Emergency','desc2' => '','desc3' => ''), |
|
array('id' => '236','code_group' => 'revenue_code','code' => '0459','desc' => 'Emergency Room: Other emergency room','desc1' => 'Emergency','desc2' => '','desc3' => ''), |
|
array('id' => '237','code_group' => 'revenue_code','code' => '0460','desc' => 'Pulmonary Function','desc1' => 'Pulmonary Function Testing','desc2' => 'Cardiopulmonary','desc3' => ''), |
|
array('id' => '238','code_group' => 'revenue_code','code' => '0469','desc' => 'Pulmonary Function: Other','desc1' => 'Pulmonary Function Testing','desc2' => 'Cardiopulmonary','desc3' => ''), |
|
array('id' => '239','code_group' => 'revenue_code','code' => '0470','desc' => 'Audiology','desc1' => 'Audiology','desc2' => 'Speech Pathology','desc3' => ''), |
|
array('id' => '240','code_group' => 'revenue_code','code' => '0471','desc' => 'Audiology: Diagnostic','desc1' => 'Audiology','desc2' => 'Speech Pathology','desc3' => ''), |
|
array('id' => '241','code_group' => 'revenue_code','code' => '0472','desc' => 'Audiology: Treatment','desc1' => 'Audiology','desc2' => 'Speech Pathology','desc3' => ''), |
|
array('id' => '242','code_group' => 'revenue_code','code' => '0479','desc' => 'Audiology: Other audiology','desc1' => 'Audiology','desc2' => 'Speech Pathology','desc3' => ''), |
|
array('id' => '243','code_group' => 'revenue_code','code' => '0480','desc' => 'Cardiology','desc1' => 'Cardiology','desc2' => '','desc3' => ''), |
|
array('id' => '244','code_group' => 'revenue_code','code' => '0481','desc' => 'Cardiology: Cardiac catheter lab','desc1' => 'Cardiac Catheterization','desc2' => 'Cardiology','desc3' => ''), |
|
array('id' => '245','code_group' => 'revenue_code','code' => '0482','desc' => 'Cardiology: Stress test','desc1' => 'Stress Test','desc2' => 'Cardiology','desc3' => ''), |
|
array('id' => '246','code_group' => 'revenue_code','code' => '0483','desc' => 'Cardiology: Echocardiology','desc1' => 'Echocardiography','desc2' => 'Cardiology','desc3' => ''), |
|
array('id' => '247','code_group' => 'revenue_code','code' => '0489','desc' => 'Cardiology: Other cardiology','desc1' => 'Cardiology','desc2' => '','desc3' => ''), |
|
array('id' => '248','code_group' => 'revenue_code','code' => '0490','desc' => 'Ambulatory Surgery','desc1' => 'ASC (Non-Distinct Part)','desc2' => 'Operating Room','desc3' => ''), |
|
array('id' => '249','code_group' => 'revenue_code','code' => '0499','desc' => 'Ambulatory Surgery: Other ambulatory surgical care','desc1' => 'ASC (Non-Distinct Part)','desc2' => 'Operating Room','desc3' => ''), |
|
array('id' => '250','code_group' => 'revenue_code','code' => '0500','desc' => 'Outpatient services','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '251','code_group' => 'revenue_code','code' => '0509','desc' => 'Other Outpatient','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '252','code_group' => 'revenue_code','code' => '0510','desc' => 'Clinic','desc1' => 'Clinic','desc2' => '','desc3' => ''), |
|
array('id' => '253','code_group' => 'revenue_code','code' => '0511','desc' => 'Clinic: Chronic pain center','desc1' => 'Clinic','desc2' => '','desc3' => ''), |
|
array('id' => '254','code_group' => 'revenue_code','code' => '0512','desc' => 'Clinic: Dental clinic','desc1' => 'Dental Services','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '255','code_group' => 'revenue_code','code' => '0513','desc' => 'Clinic: Psychiatric clinic','desc1' => 'Psychiatric/Psychological Services','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '256','code_group' => 'revenue_code','code' => '0514','desc' => 'Clinic: OB/GYN clinic','desc1' => 'Clinic','desc2' => '','desc3' => ''), |
|
array('id' => '257','code_group' => 'revenue_code','code' => '0515','desc' => 'Clinic: Pediatric clinic','desc1' => 'Clinic','desc2' => '','desc3' => ''), |
|
array('id' => '258','code_group' => 'revenue_code','code' => '0516','desc' => 'Clinic: Urgent care clinic','desc1' => 'Clinic','desc2' => '','desc3' => ''), |
|
array('id' => '259','code_group' => 'revenue_code','code' => '0517','desc' => 'Clinic: Family clinic','desc1' => 'Family Practice','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '260','code_group' => 'revenue_code','code' => '0519','desc' => 'Clinic: Other clinic','desc1' => 'Clinic','desc2' => '','desc3' => ''), |
|
array('id' => '261','code_group' => 'revenue_code','code' => '0520','desc' => 'Free-Standing Clinic','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '262','code_group' => 'revenue_code','code' => '0521','desc' => 'Rural health-clinic','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '263','code_group' => 'revenue_code','code' => '0522','desc' => 'Rural health-home','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '264','code_group' => 'revenue_code','code' => '0523','desc' => 'Family Practice Clinic','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '265','code_group' => 'revenue_code','code' => '0524','desc' => 'RHC/FQHC visit in Part A covered SNF','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '266','code_group' => 'revenue_code','code' => '0525','desc' => 'RHC/FQHC visit in noncovered SNF, NF, ICFMR or other','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '267','code_group' => 'revenue_code','code' => '0526','desc' => 'Urgent Care Clinic','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '268','code_group' => 'revenue_code','code' => '0527','desc' => 'Nurse visit to home in a HH shortage area','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '269','code_group' => 'revenue_code','code' => '0528','desc' => 'RHC/FQHC visit to other non RHC/FQHC site','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '270','code_group' => 'revenue_code','code' => '0529','desc' => 'Free-Standing Clinic: Other','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '271','code_group' => 'revenue_code','code' => '0530','desc' => 'Osteopathic Services','desc1' => 'Osteopathic Therapy','desc2' => '','desc3' => ''), |
|
array('id' => '272','code_group' => 'revenue_code','code' => '0531','desc' => 'Osteopathic Services: Osteopathic therapy','desc1' => 'Osteopathic Therapy','desc2' => '','desc3' => ''), |
|
array('id' => '273','code_group' => 'revenue_code','code' => '0539','desc' => 'Osteopathic Services: Other osteopathic services','desc1' => 'Osteopathic Therapy','desc2' => '','desc3' => ''), |
|
array('id' => '274','code_group' => 'revenue_code','code' => '0540','desc' => 'Ambulance','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '275','code_group' => 'revenue_code','code' => '0541','desc' => 'Supplies','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '276','code_group' => 'revenue_code','code' => '0542','desc' => 'Medical Transport','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '277','code_group' => 'revenue_code','code' => '0543','desc' => 'Heart Mobile','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '278','code_group' => 'revenue_code','code' => '0544','desc' => 'Oxygen','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '279','code_group' => 'revenue_code','code' => '0545','desc' => 'Air ambulance','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '280','code_group' => 'revenue_code','code' => '0546','desc' => 'Neonatal ambulance services','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '281','code_group' => 'revenue_code','code' => '0547','desc' => 'Pharmacy','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '282','code_group' => 'revenue_code','code' => '0548','desc' => 'Telephone Transmission EKG','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '283','code_group' => 'revenue_code','code' => '0549','desc' => 'Other ambulance','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '284','code_group' => 'revenue_code','code' => '0550','desc' => 'Skilled nursing','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '285','code_group' => 'revenue_code','code' => '0551','desc' => 'Visit charge','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '286','code_group' => 'revenue_code','code' => '0552','desc' => 'Hourly charge','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '287','code_group' => 'revenue_code','code' => '0559','desc' => 'Other skilled nursing','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '288','code_group' => 'revenue_code','code' => '0560','desc' => 'Home Health (HH) -- Medical Social Services','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '289','code_group' => 'revenue_code','code' => '0561','desc' => 'Home Heath (HH) Medical Social Services: Visit charge','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '290','code_group' => 'revenue_code','code' => '0562','desc' => 'Home Health (HH) Medical Social Services: Hourly charge','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '291','code_group' => 'revenue_code','code' => '0569','desc' => 'Home Health (HH) Medical Social Services: Other Medical Social Services','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '292','code_group' => 'revenue_code','code' => '0570','desc' => 'Home health-Home health aide','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '293','code_group' => 'revenue_code','code' => '0571','desc' => 'Visit charge','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '294','code_group' => 'revenue_code','code' => '0572','desc' => 'Hourly charge','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '295','code_group' => 'revenue_code','code' => '0579','desc' => 'Other home health aide','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '296','code_group' => 'revenue_code','code' => '0580','desc' => 'Home health-other visits','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '297','code_group' => 'revenue_code','code' => '0581','desc' => 'Visit charge','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '298','code_group' => 'revenue_code','code' => '0582','desc' => 'Hourly charge','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '299','code_group' => 'revenue_code','code' => '0583','desc' => 'Assessment','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '300','code_group' => 'revenue_code','code' => '0589','desc' => 'Other home health visit','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '301','code_group' => 'revenue_code','code' => '0590','desc' => 'Home health-units of service','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '302','code_group' => 'revenue_code','code' => '0600','desc' => 'Home health-oxygen','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '303','code_group' => 'revenue_code','code' => '0601','desc' => 'Oxygen-state/equip/suppl/ or cont','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '304','code_group' => 'revenue_code','code' => '0602','desc' => 'Oxygen-state/equip/suppl/ or under 1 LPM','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '305','code_group' => 'revenue_code','code' => '0603','desc' => 'Oxygen-state/equip/over 4 LPM','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '306','code_group' => 'revenue_code','code' => '0604','desc' => 'Oxygen-Portable Add-on','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '307','code_group' => 'revenue_code','code' => '0609','desc' => 'Other oxygen','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '308','code_group' => 'revenue_code','code' => '0610','desc' => 'Magnetic Resonance Tech. (MRT)','desc1' => 'Magnetic Resonance Imaging (MRI)','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '309','code_group' => 'revenue_code','code' => '0611','desc' => 'Magnetic Resonance Tech. (MRT): Brain (incl. Brainstem)','desc1' => 'Magnetic Resonance Imaging (MRI)','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '310','code_group' => 'revenue_code','code' => '0612','desc' => 'Magnetic Resonance Tech. (MRT): Spinal cord (incl. spine)','desc1' => 'Magnetic Resonance Imaging (MRI)','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '311','code_group' => 'revenue_code','code' => '0614','desc' => 'Magnetic Resonance Tech. (MRT): MRI - Other','desc1' => 'Magnetic Resonance Imaging (MRI)','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '312','code_group' => 'revenue_code','code' => '0615','desc' => 'Magnetic Resonance Tech. (MRT): MRA - Head and Neck','desc1' => 'Magnetic Resonance Imaging (MRI)','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '313','code_group' => 'revenue_code','code' => '0616','desc' => 'Magnetic Resonance Tech. (MRT): MRA - Lower Ext','desc1' => 'Magnetic Resonance Imaging (MRI)','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '314','code_group' => 'revenue_code','code' => '0618','desc' => 'Magnetic Resonance Tech. (MRT): MRA - Other','desc1' => 'Magnetic Resonance Imaging (MRI)','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '315','code_group' => 'revenue_code','code' => '0619','desc' => 'Magnetic Resonance Tech. (MRT): Other MRT','desc1' => 'Magnetic Resonance Imaging (MRI)','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '316','code_group' => 'revenue_code','code' => '0621','desc' => 'Med - Surg Supplies Ext. of 270: Incident to radiology','desc1' => 'Medical Supplies Charged to Patients','desc2' => 'Radiology - Diagnostic','desc3' => 'Radiology - Therapeutic'), |
|
array('id' => '317','code_group' => 'revenue_code','code' => '0622','desc' => 'Med - Surg Supplies Ext. of 270: Incident to other diag.','desc1' => 'Medical Supplies Charged to Patients','desc2' => '','desc3' => ''), |
|
array('id' => '318','code_group' => 'revenue_code','code' => '0623','desc' => 'Surgical dressings','desc1' => 'Medical Supplies Charged to Patients','desc2' => '','desc3' => ''), |
|
array('id' => '319','code_group' => 'revenue_code','code' => '0624','desc' => 'Med - Surg Supplies Ext. of 270: Investigational Device (IDE)','desc1' => 'Impl. Dev. Charged to Patient','desc2' => 'Medical Supplies Charged to Patients','desc3' => ''), |
|
array('id' => '320','code_group' => 'revenue_code','code' => '0631','desc' => 'Drugs Require Specific ID: Single source drug','desc1' => 'Drugs Charged to Patients','desc2' => '','desc3' => ''), |
|
array('id' => '321','code_group' => 'revenue_code','code' => '0632','desc' => 'Drugs Require Specific ID: Multiple source drug','desc1' => 'Drugs Charged to Patients','desc2' => '','desc3' => ''), |
|
array('id' => '322','code_group' => 'revenue_code','code' => '0633','desc' => 'Drugs Require Specific ID: Restrictive prescription','desc1' => 'Drugs Charged to Patients','desc2' => '','desc3' => ''), |
|
array('id' => '323','code_group' => 'revenue_code','code' => '0634','desc' => 'Drugs Require Specific ID: EPO under 10,000 units','desc1' => 'Drugs Charged to Patients','desc2' => '','desc3' => ''), |
|
array('id' => '324','code_group' => 'revenue_code','code' => '0635','desc' => 'Drugs Require Specific ID: EPO over 10,000 units','desc1' => 'Drugs Charged to Patients','desc2' => '','desc3' => ''), |
|
array('id' => '325','code_group' => 'revenue_code','code' => '0636','desc' => 'Drugs Require Specific ID: Drugs requiring detail coding','desc1' => 'Drugs Charged to Patients','desc2' => '','desc3' => ''), |
|
array('id' => '326','code_group' => 'revenue_code','code' => '0637','desc' => 'Drugs Require Specific ID: Self admin drugs (insulin admin in emergency-diabetes coma)','desc1' => 'Drugs Charged to Patients','desc2' => '','desc3' => ''), |
|
array('id' => '327','code_group' => 'revenue_code','code' => '0640','desc' => 'Home IV Therapy Services','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '328','code_group' => 'revenue_code','code' => '0641','desc' => 'Nonroutine nursing, central line','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '329','code_group' => 'revenue_code','code' => '0642','desc' => 'IV site care, Central line','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '330','code_group' => 'revenue_code','code' => '0643','desc' => 'IV start/change, peripheral line','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '331','code_group' => 'revenue_code','code' => '0644','desc' => 'Nonroutine nursing, peripheral line','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '332','code_group' => 'revenue_code','code' => '0645','desc' => 'Training patient/caregiver, central line','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '333','code_group' => 'revenue_code','code' => '0646','desc' => 'Training, Disabled patient, central line','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '334','code_group' => 'revenue_code','code' => '0647','desc' => 'Training, patient/caregiver, peripheral line','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '335','code_group' => 'revenue_code','code' => '0648','desc' => 'Training, disabled patient, peripheral line','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '336','code_group' => 'revenue_code','code' => '0649','desc' => 'Other IV therapy services','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '337','code_group' => 'revenue_code','code' => '0650','desc' => 'Hospice service','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '338','code_group' => 'revenue_code','code' => '0651','desc' => 'routine home care','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '339','code_group' => 'revenue_code','code' => '0652','desc' => 'continuous home care','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '340','code_group' => 'revenue_code','code' => '0655','desc' => 'inpatient respite care','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '341','code_group' => 'revenue_code','code' => '0656','desc' => 'general inpatient care (non-respite)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '342','code_group' => 'revenue_code','code' => '0657','desc' => 'physician services','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '343','code_group' => 'revenue_code','code' => '0658','desc' => 'Hospice Room & Board-Nursing facility','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '344','code_group' => 'revenue_code','code' => '0659','desc' => 'Other hospice service','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '345','code_group' => 'revenue_code','code' => '0660','desc' => 'Respite Care','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '346','code_group' => 'revenue_code','code' => '0661','desc' => 'Hourly Repite Care Charge Nursing','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '347','code_group' => 'revenue_code','code' => '0662','desc' => 'Hourly Respite Care Charge Aide/Homemaker/Companion','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '348','code_group' => 'revenue_code','code' => '0663','desc' => 'Daily Respite Charge','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '349','code_group' => 'revenue_code','code' => '0669','desc' => 'Other respite care','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '350','code_group' => 'revenue_code','code' => '0670','desc' => 'Outpatient Special Residence Charges','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '351','code_group' => 'revenue_code','code' => '0671','desc' => 'Hospital based','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '352','code_group' => 'revenue_code','code' => '0672','desc' => 'Contracted','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '353','code_group' => 'revenue_code','code' => '0679','desc' => 'Other special residence charge','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '354','code_group' => 'revenue_code','code' => '0680','desc' => 'Not Used','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '355','code_group' => 'revenue_code','code' => '0681','desc' => 'Trauma Response: Level I','desc1' => 'Emergency','desc2' => '','desc3' => ''), |
|
array('id' => '356','code_group' => 'revenue_code','code' => '0682','desc' => 'Trauma Response: Level II','desc1' => 'Emergency','desc2' => '','desc3' => ''), |
|
array('id' => '357','code_group' => 'revenue_code','code' => '0683','desc' => 'Trauma Response: Level III','desc1' => 'Emergency','desc2' => '','desc3' => ''), |
|
array('id' => '358','code_group' => 'revenue_code','code' => '0684','desc' => 'Trauma Response: Level IV','desc1' => 'Emergency','desc2' => '','desc3' => ''), |
|
array('id' => '359','code_group' => 'revenue_code','code' => '0689','desc' => 'Trauma Response: Other','desc1' => 'Emergency','desc2' => '','desc3' => ''), |
|
array('id' => '360','code_group' => 'revenue_code','code' => '0700','desc' => 'Cast Room','desc1' => 'Clinic','desc2' => '','desc3' => ''), |
|
array('id' => '361','code_group' => 'revenue_code','code' => '0710','desc' => 'Recovery Room','desc1' => 'Recovery Room','desc2' => '','desc3' => ''), |
|
array('id' => '362','code_group' => 'revenue_code','code' => '0720','desc' => 'Labor Room','desc1' => 'Delivery Room & Labor Room','desc2' => '','desc3' => ''), |
|
array('id' => '363','code_group' => 'revenue_code','code' => '0721','desc' => 'Labor Room: Labor','desc1' => 'Delivery Room & Labor Room','desc2' => '','desc3' => ''), |
|
array('id' => '364','code_group' => 'revenue_code','code' => '0722','desc' => 'Labor Room: Delivery','desc1' => 'Delivery Room & Labor Room','desc2' => '','desc3' => ''), |
|
array('id' => '365','code_group' => 'revenue_code','code' => '0723','desc' => 'Labor Room: Circumcision','desc1' => 'Circumcision','desc2' => 'Delivery Room & Labor Room','desc3' => ''), |
|
array('id' => '366','code_group' => 'revenue_code','code' => '0724','desc' => 'Labor Room: Birthing center','desc1' => 'Birthing Center','desc2' => 'Delivery Room & Labor Room','desc3' => ''), |
|
array('id' => '367','code_group' => 'revenue_code','code' => '0729','desc' => 'Labor Room: Other labor room/delivery','desc1' => 'Delivery Room & Labor Room','desc2' => '','desc3' => ''), |
|
array('id' => '368','code_group' => 'revenue_code','code' => '0730','desc' => 'EKG/ECG','desc1' => 'EKG and EEG','desc2' => 'Electro cardiology','desc3' => 'Cardiology'), |
|
array('id' => '369','code_group' => 'revenue_code','code' => '0731','desc' => 'EKG/ECG: Holter monitor','desc1' => 'Holter Monitor','desc2' => 'Electro cardiology','desc3' => 'Cardiology'), |
|
array('id' => '370','code_group' => 'revenue_code','code' => '0732','desc' => 'EKG/ECG: Telemetry','desc1' => 'EKG and EEG','desc2' => 'Electro cardiology','desc3' => 'Cardiology'), |
|
array('id' => '371','code_group' => 'revenue_code','code' => '0739','desc' => 'EKG/ECG: Other EKG/ECG','desc1' => 'EKG and EEG','desc2' => 'Electro cardiology','desc3' => 'Cardiology'), |
|
array('id' => '372','code_group' => 'revenue_code','code' => '0740','desc' => 'EEG','desc1' => 'EKG and EEG','desc2' => 'Electroencephalography','desc3' => ''), |
|
array('id' => '373','code_group' => 'revenue_code','code' => '0750','desc' => 'Gastrointestinal','desc1' => 'Gastro Intestinal Services','desc2' => '','desc3' => ''), |
|
array('id' => '374','code_group' => 'revenue_code','code' => '0760','desc' => 'Treatment/Observation Room','desc1' => 'Clinic','desc2' => '','desc3' => ''), |
|
array('id' => '375','code_group' => 'revenue_code','code' => '0761','desc' => 'Treatment/Observation Room: Treatment room','desc1' => 'Clinic','desc2' => '','desc3' => ''), |
|
array('id' => '376','code_group' => 'revenue_code','code' => '0762','desc' => 'Treatment/Observation Room: Observation room','desc1' => 'Observation Beds (Distinct Part)','desc2' => 'Observation Beds (Non-Distinct Part)','desc3' => ''), |
|
array('id' => '377','code_group' => 'revenue_code','code' => '0769','desc' => 'Treatment/Observation Room: Other treatment room','desc1' => 'Clinic','desc2' => '','desc3' => ''), |
|
array('id' => '378','code_group' => 'revenue_code','code' => '0770','desc' => 'Preventive Care Services','desc1' => 'Clinic','desc2' => '','desc3' => ''), |
|
array('id' => '379','code_group' => 'revenue_code','code' => '0771','desc' => 'Preventive Care Services: Admin. of vaccine','desc1' => 'Clinic','desc2' => '','desc3' => ''), |
|
array('id' => '380','code_group' => 'revenue_code','code' => '0780','desc' => 'Telemedicine','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '381','code_group' => 'revenue_code','code' => '0790','desc' => 'Extra-Corp Shock Wave Therapy','desc1' => 'Urology','desc2' => '','desc3' => ''), |
|
array('id' => '382','code_group' => 'revenue_code','code' => '0800','desc' => 'Inpatient Dialysis','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '383','code_group' => 'revenue_code','code' => '0801','desc' => 'Inpatient Hemodialysis','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '384','code_group' => 'revenue_code','code' => '0802','desc' => 'Inpatient peritoneal dialysis','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '385','code_group' => 'revenue_code','code' => '0803','desc' => 'inpatient dialysis CAPD','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '386','code_group' => 'revenue_code','code' => '0804','desc' => 'Inpatient dialysis CCPD','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '387','code_group' => 'revenue_code','code' => '0809','desc' => 'Other inp dialysis','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '388','code_group' => 'revenue_code','code' => '0810','desc' => 'Organ Acquisition','desc1' => 'Other Organ Acquisition (specify)','desc2' => '','desc3' => ''), |
|
array('id' => '389','code_group' => 'revenue_code','code' => '0811','desc' => 'Organ Acquisition: Living donor','desc1' => 'Other Organ Acquisition (specify)','desc2' => '','desc3' => ''), |
|
array('id' => '390','code_group' => 'revenue_code','code' => '0812','desc' => 'Organ Acquisition: Cadaver donor','desc1' => 'Other Organ Acquisition (specify)','desc2' => '','desc3' => ''), |
|
array('id' => '391','code_group' => 'revenue_code','code' => '0813','desc' => 'Organ Acquisition: Unknown donor','desc1' => 'Other Organ Acquisition (specify)','desc2' => '','desc3' => ''), |
|
array('id' => '392','code_group' => 'revenue_code','code' => '0814','desc' => 'Organ Acquisition: Unsuccessful Organ Search Donor Bank Charges','desc1' => 'Other Organ Acquisition (specify)','desc2' => '','desc3' => ''), |
|
array('id' => '393','code_group' => 'revenue_code','code' => '0819','desc' => 'Organ Acquisition: Other donor','desc1' => 'Other Organ Acquisition (specify)','desc2' => '','desc3' => ''), |
|
array('id' => '394','code_group' => 'revenue_code','code' => '0820','desc' => 'Hemo OPD/Home','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '395','code_group' => 'revenue_code','code' => '0821','desc' => 'Hemo OPD/Home: Hemodialysis comp or other rate','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '396','code_group' => 'revenue_code','code' => '0822','desc' => 'Hemo OPD/Home supplies','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '397','code_group' => 'revenue_code','code' => '0823','desc' => 'Hemo OPD/home equipment','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '398','code_group' => 'revenue_code','code' => '0824','desc' => 'Hemo OPD/Home Maintenance 100%','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '399','code_group' => 'revenue_code','code' => '0825','desc' => 'Hemo OPD/Home Support Services','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '400','code_group' => 'revenue_code','code' => '0829','desc' => 'Hemo OPD/Home: Other HEMO outpatient','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '401','code_group' => 'revenue_code','code' => '0830','desc' => 'Peritoneal OPD/Home','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '402','code_group' => 'revenue_code','code' => '0831','desc' => 'Peritoneal OPD/Home: Peritoneal comp or other rate','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '403','code_group' => 'revenue_code','code' => '0832','desc' => 'Home supplies','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '404','code_group' => 'revenue_code','code' => '0833','desc' => 'Home equipment','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '405','code_group' => 'revenue_code','code' => '0834','desc' => 'Maintenance/100%','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '406','code_group' => 'revenue_code','code' => '0835','desc' => 'Support services','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '407','code_group' => 'revenue_code','code' => '0839','desc' => 'Peritoneal OPD/Home: Other peritoneal dialysis','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '408','code_group' => 'revenue_code','code' => '0840','desc' => 'CAPD OPD/Home','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '409','code_group' => 'revenue_code','code' => '0841','desc' => 'CAPD OPD/Home: CAPD comp or other rate','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '410','code_group' => 'revenue_code','code' => '0842','desc' => 'Home supplies','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '411','code_group' => 'revenue_code','code' => '0843','desc' => 'Home equipment','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '412','code_group' => 'revenue_code','code' => '0844','desc' => 'Maintenance/100%','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '413','code_group' => 'revenue_code','code' => '0845','desc' => 'Support services','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '414','code_group' => 'revenue_code','code' => '0849','desc' => 'CAPD OPD/Home: Other CAPD dialysis','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '415','code_group' => 'revenue_code','code' => '0850','desc' => 'CCPD OPD/Home','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '416','code_group' => 'revenue_code','code' => '0851','desc' => 'CCPD OPD/Home: CCPD comp or other rate','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '417','code_group' => 'revenue_code','code' => '0852','desc' => 'Home supplies','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '418','code_group' => 'revenue_code','code' => '0853','desc' => 'Home equipment','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '419','code_group' => 'revenue_code','code' => '0854','desc' => 'Maintenance/100%','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '420','code_group' => 'revenue_code','code' => '0855','desc' => 'Support services','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '421','code_group' => 'revenue_code','code' => '0859','desc' => 'CCPD OPD/Home: Other CCPD dialysis','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '422','code_group' => 'revenue_code','code' => '0860','desc' => 'Magnetoencehpahlography (MEG)','desc1' => 'EKG and EEG','desc2' => 'Electroencephalography','desc3' => ''), |
|
array('id' => '423','code_group' => 'revenue_code','code' => '0861','desc' => 'MEG','desc1' => 'EKG and EEG','desc2' => 'Electroencephalography','desc3' => ''), |
|
array('id' => '424','code_group' => 'revenue_code','code' => '0880','desc' => 'Miscellaneous Dialysis','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '425','code_group' => 'revenue_code','code' => '0881','desc' => 'Miscellaneous Dialysis: Ultrafiltration','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '426','code_group' => 'revenue_code','code' => '0882','desc' => 'Home dialysis aid visit','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '427','code_group' => 'revenue_code','code' => '0889','desc' => 'Miscellaneous Dialysis: Other misc dialysis','desc1' => 'Renal Dialysis','desc2' => '','desc3' => ''), |
|
array('id' => '428','code_group' => 'revenue_code','code' => '0900','desc' => 'Psychiatric/Psychological Trt','desc1' => 'Psychiatric/Psychological Services','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '429','code_group' => 'revenue_code','code' => '0901','desc' => 'Psychiatric/Psychological Trt: Electroshock treatment','desc1' => 'Electroshock Therapy','desc2' => 'Psychiatric/Psychological Services','desc3' => 'Operating Room'), |
|
array('id' => '430','code_group' => 'revenue_code','code' => '0902','desc' => 'Psychiatric/Psychological Trt: Milieu therapy','desc1' => 'Psychiatric/Psychological Services','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '431','code_group' => 'revenue_code','code' => '0903','desc' => 'Psychiatric/Psychological Trt: Play therapy','desc1' => 'Psychiatric/Psychological Services','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '432','code_group' => 'revenue_code','code' => '0904','desc' => 'Psychiatric/Psychological Trt: Activity therapy','desc1' => 'Recreational Therapy','desc2' => 'Psychiatric/Psychological Services','desc3' => 'Clinic'), |
|
array('id' => '433','code_group' => 'revenue_code','code' => '0905','desc' => 'Psychiatric/Psychological Trt: Intensive Outpatient serv-sych','desc1' => 'Psychiatric/Psychological Services','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '434','code_group' => 'revenue_code','code' => '0906','desc' => 'Psychiatric/Psychological Trt: Intensive out serv - chem dep','desc1' => 'Psychiatric/Psychological Services','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '435','code_group' => 'revenue_code','code' => '0907','desc' => 'Psychiatric/Psychological Trt: Comm behavioral program','desc1' => 'Psychiatric/Psychological Services','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '436','code_group' => 'revenue_code','code' => '0911','desc' => 'Psychiatric/Psychological Svcs: Rehabilitation','desc1' => 'Psychiatric/Psychological Services','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '437','code_group' => 'revenue_code','code' => '0912','desc' => 'Psychiatric/Psychological Svcs: Partial Hosp - less intensive','desc1' => 'Psychiatric/Psychological Services','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '438','code_group' => 'revenue_code','code' => '0913','desc' => 'Psychiatric/Psychological Svcs: Partial Hosp - Intensive','desc1' => 'Psychiatric/Psychological Services','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '439','code_group' => 'revenue_code','code' => '0914','desc' => 'Psychiatric/Psychological Svcs: Individual therapy','desc1' => 'Psychiatric/Psychological Services','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '440','code_group' => 'revenue_code','code' => '0915','desc' => 'Psychiatric/Psychological Svcs: Group therapy','desc1' => 'Psychiatric/Psychological Services','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '441','code_group' => 'revenue_code','code' => '0916','desc' => 'Psychiatric/Psychological Svcs: Family therapy','desc1' => 'Psychiatric/Psychological Services','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '442','code_group' => 'revenue_code','code' => '0917','desc' => 'Psychiatric/Psychological Svcs: Biofeedback','desc1' => 'Psychiatric/Psychological Services','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '443','code_group' => 'revenue_code','code' => '0918','desc' => 'Psychiatric/Psychological Svcs: Testing','desc1' => 'Psychiatric/Psychological Services','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '444','code_group' => 'revenue_code','code' => '0919','desc' => 'Psychiatric/Psychological Svcs: Other behavioral treat/serv','desc1' => 'Psychiatric/Psychological Services','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '445','code_group' => 'revenue_code','code' => '0920','desc' => 'Other Diagnostic Services','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '446','code_group' => 'revenue_code','code' => '0921','desc' => 'Other Diagnostic Services: Peripheral vascular lab','desc1' => 'Vascular Lab','desc2' => 'Radiology - Diagnostic','desc3' => ''), |
|
array('id' => '447','code_group' => 'revenue_code','code' => '0922','desc' => 'Other Diagnostic Services: Electromyelogram','desc1' => 'Electromyography','desc2' => '','desc3' => ''), |
|
array('id' => '448','code_group' => 'revenue_code','code' => '0923','desc' => 'Other Diagnostic Services: Pap smear','desc1' => 'Cytology','desc2' => 'Laboratory - Pathological','desc3' => 'Laboratory'), |
|
array('id' => '449','code_group' => 'revenue_code','code' => '0924','desc' => 'Other Diagnostic Services: Allergy test','desc1' => 'Immunology','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '450','code_group' => 'revenue_code','code' => '0925','desc' => 'Other Diagnostic Services: Pregnancy test','desc1' => 'Laboratory - Clinical','desc2' => 'PBP Clinical Lab. Service - Prgm. Only','desc3' => ''), |
|
array('id' => '451','code_group' => 'revenue_code','code' => '0929','desc' => 'Other Diagnostic Services: Other diagnostic services','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '452','code_group' => 'revenue_code','code' => '0931','desc' => 'Medical rehab; half day','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '453','code_group' => 'revenue_code','code' => '0932','desc' => 'Medical rehab; full day','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '454','code_group' => 'revenue_code','code' => '0940','desc' => 'Other Therapeutic Serv','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '455','code_group' => 'revenue_code','code' => '0941','desc' => 'Other Therapeutic Serv: Recreation Rx','desc1' => 'Clinic','desc2' => '','desc3' => ''), |
|
array('id' => '456','code_group' => 'revenue_code','code' => '0942','desc' => 'Other Therapeutic Serv: Educ/training','desc1' => 'Clinic','desc2' => '','desc3' => ''), |
|
array('id' => '457','code_group' => 'revenue_code','code' => '0943','desc' => 'Other Therapeutic Serv: Cardiac rehab','desc1' => 'Cardiology','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '458','code_group' => 'revenue_code','code' => '0944','desc' => 'Other Therapeutic Serv: Drug rehab','desc1' => 'Psychiatric/Psychological Services','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '459','code_group' => 'revenue_code','code' => '0945','desc' => 'Other Therapeutic Serv: Alcohol rehab','desc1' => 'Psychiatric/Psychological Services','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '460','code_group' => 'revenue_code','code' => '0946','desc' => 'Complex medical equipment-Routine','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '461','code_group' => 'revenue_code','code' => '0947','desc' => 'Complex medical equipment-Ancillary','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '462','code_group' => 'revenue_code','code' => '0948','desc' => 'Pulmonary Rehabilitation','desc1' => 'Respiratory Therapy','desc2' => 'Clinic','desc3' => ''), |
|
array('id' => '463','code_group' => 'revenue_code','code' => '0949','desc' => 'Other Therapeutic Serv: Additional RX SVS','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '464','code_group' => 'revenue_code','code' => '0951','desc' => 'Other therapeutic services-(940x) Athletic training','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '465','code_group' => 'revenue_code','code' => '0952','desc' => 'Other therapeutic services-(940x) Kinesiotherapy','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '466','code_group' => 'revenue_code','code' => '0960','desc' => 'Professional fees','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '467','code_group' => 'revenue_code','code' => '0961','desc' => 'Psychiatric','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '468','code_group' => 'revenue_code','code' => '0962','desc' => 'Ophthalmology','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '469','code_group' => 'revenue_code','code' => '0963','desc' => 'Anesthesiologist (MD)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '470','code_group' => 'revenue_code','code' => '0964','desc' => 'Anesthetist (CRNA)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '471','code_group' => 'revenue_code','code' => '0969','desc' => 'Other professional fee','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '472','code_group' => 'revenue_code','code' => '0971','desc' => 'Professional fees (096x) Laboratory','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '473','code_group' => 'revenue_code','code' => '0972','desc' => 'Professional fees (096x) Radiology-Diagnostic','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '474','code_group' => 'revenue_code','code' => '0973','desc' => 'Professional fees (096x) Radiology-Therapeutic','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '475','code_group' => 'revenue_code','code' => '0974','desc' => 'Professional fees (096x) Radiology-nuclear medicine','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '476','code_group' => 'revenue_code','code' => '0975','desc' => 'Professional fees (096x) Operating room','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '477','code_group' => 'revenue_code','code' => '0976','desc' => 'Professional fees (096x) Respiratory Therapy','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '478','code_group' => 'revenue_code','code' => '0977','desc' => 'Professional fees (096x) Physical therapy','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '479','code_group' => 'revenue_code','code' => '0978','desc' => 'Professional fees (096x) Occupational therapy','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '480','code_group' => 'revenue_code','code' => '0979','desc' => 'Professional fees (096x) Speech pathology','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '481','code_group' => 'revenue_code','code' => '0981','desc' => 'Professional fees (096x) Emergency room','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '482','code_group' => 'revenue_code','code' => '0982','desc' => 'Professional fees (096x) Outpatient services','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '483','code_group' => 'revenue_code','code' => '0983','desc' => 'Professional fees (096x) clinic','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '484','code_group' => 'revenue_code','code' => '0984','desc' => 'Professional fees (096x) medical social services','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '485','code_group' => 'revenue_code','code' => '0985','desc' => 'Professional fees (096x) EKG','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '486','code_group' => 'revenue_code','code' => '0986','desc' => 'Professional fees (096x) EEK','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '487','code_group' => 'revenue_code','code' => '0987','desc' => 'Professional fees (096x) Hospital visit','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '488','code_group' => 'revenue_code','code' => '0988','desc' => 'Professional fees (096x) Consultation','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '489','code_group' => 'revenue_code','code' => '0989','desc' => 'Private duty nurse','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '490','code_group' => 'revenue_code','code' => '0990','desc' => 'Patient convenience items','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '491','code_group' => 'revenue_code','code' => '0991','desc' => 'Cafeteria/guest tray','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '492','code_group' => 'revenue_code','code' => '0992','desc' => 'private linen service','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '493','code_group' => 'revenue_code','code' => '0993','desc' => 'telephone/telegraph','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '494','code_group' => 'revenue_code','code' => '0994','desc' => 'TV/radio','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '495','code_group' => 'revenue_code','code' => '0995','desc' => 'Nonpatient room rentals','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '496','code_group' => 'revenue_code','code' => '0996','desc' => 'Late discharge charge','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '497','code_group' => 'revenue_code','code' => '0997','desc' => 'admission kits','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '498','code_group' => 'revenue_code','code' => '0998','desc' => 'Beauty shop/barber','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '499','code_group' => 'revenue_code','code' => '0999','desc' => 'Other patient convenience item','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '500','code_group' => 'revenue_code','code' => '1000','desc' => 'Behavioral health accomodations','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '501','code_group' => 'revenue_code','code' => '1001','desc' => 'Residential treatment-psychiatric','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '502','code_group' => 'revenue_code','code' => '1002','desc' => 'residential treatment-chemical dependency','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '503','code_group' => 'revenue_code','code' => '1003','desc' => 'Supervised living','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '504','code_group' => 'revenue_code','code' => '1004','desc' => 'halfway house','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '505','code_group' => 'revenue_code','code' => '1005','desc' => 'group home','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '506','code_group' => 'revenue_code','code' => '2100','desc' => 'Alternative therapy services','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '507','code_group' => 'revenue_code','code' => '2101','desc' => 'acupuncture','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '508','code_group' => 'revenue_code','code' => '2102','desc' => 'acupressure','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '509','code_group' => 'revenue_code','code' => '2103','desc' => 'massage','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '510','code_group' => 'revenue_code','code' => '2104','desc' => 'reflexology','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '511','code_group' => 'revenue_code','code' => '2105','desc' => 'biofeedback','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '512','code_group' => 'revenue_code','code' => '2106','desc' => 'hypnosis','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '513','code_group' => 'revenue_code','code' => '2109','desc' => 'Other alternative therapy services','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '514','code_group' => 'revenue_code','code' => '3101','desc' => 'Adult day care, Medical and social, hourly','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '515','code_group' => 'revenue_code','code' => '3102','desc' => 'Adult day care, social, hourly','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '516','code_group' => 'revenue_code','code' => '3103','desc' => 'Adult day care, medical and social, daily','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '517','code_group' => 'revenue_code','code' => '3104','desc' => 'Adult day care, social, daily','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '518','code_group' => 'revenue_code','code' => '3105','desc' => 'Adult foster care, daily','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '519','code_group' => 'revenue_code','code' => '3109','desc' => 'Other adult care','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '520','code_group' => 'condition_code','code' => 'MA','desc' => 'Gastroenteritis (GI) bleed','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '521','code_group' => 'condition_code','code' => 'MB','desc' => 'Pneumonia (Not used – effective 01/01/2016)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '522','code_group' => 'condition_code','code' => 'MC','desc' => 'Pericarditis','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '523','code_group' => 'condition_code','code' => 'MD','desc' => 'Myelodysplastic Syndrome','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '524','code_group' => 'condition_code','code' => 'ME','desc' => 'Hereditary Hemolytic and Sickle Cell Anemia','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '525','code_group' => 'condition_code','code' => 'MR','desc' => 'Monoclonal Gammopathy (Not used – effective 01/01/2016)','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '526','code_group' => 'condition_code','code' => 'H3','desc' => 'Reoccurrence of GI bleed.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '527','code_group' => 'condition_code','code' => 'H4','desc' => 'Reoccurrence of Pneumonia (CWF no longer tracks condition code H4 for dates of service on or after 01/01/2016).','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '528','code_group' => 'condition_code','code' => 'H5','desc' => 'Reoccurrence of pericarditis.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '529','code_group' => 'condition_code','code' => 'D0','desc' => 'zero) - Use when the from and thru date of the claim is changed.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '530','code_group' => 'condition_code','code' => 'D7','desc' => 'Use used when the original claim shows Medicare on the primary payer line and now the adjustment claim shows Medicare on the secondary payer line.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '531','code_group' => 'condition_code','code' => 'D8','desc' => 'Use when the original claim shows Medicare on the secondary payer line and now the adjustment claim shows Medicare on the primary payer line.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '532','code_group' => 'condition_code','code' => 'D2','desc' => 'Use when there is a change to the revenue codes, HCPCS code, RUG code, or HIPPS code.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '533','code_group' => 'condition_code','code' => 'If','desc' => 'nly removing procedure codes or diagnosis codes, D9 would be more appropriate.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '534','code_group' => 'condition_code','code' => 'D3','desc' => 'Use for a second or subsequent interim claim by inpatient PPS hospitals only.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '535','code_group' => 'condition_code','code' => 'D4','desc' => 'Change in grouper input (ICD-9/ICD-10 Diagnosis codes and ICD-9/ICD-10 Procedure codes)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '536','code_group' => 'condition_code','code' => 'D5','desc' => 'Use when canceling a claim to correct the Health Insurance Claim Number (HICN) or provider number.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '537','code_group' => 'condition_code','code' => 'D6','desc' => 'Use when canceling a claim for reasons other than the HICN or provider number. Use when canceling a claim to repay a payment.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '538','code_group' => 'condition_code','code' => 'D1','desc' => 'If one of the above condition codes does not apply and there is a change to the COVERED charges this code should be used.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '539','code_group' => 'condition_code','code' => 'E0','desc' => 'Zero) - Use when the only change on the claim is a correction to the patient status code.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '540','code_group' => 'condition_code','code' => 'D9','desc' => 'Used for adjustments not described in any other condition codes. Remarks are required when using the D9 condition code to make a change.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '541','code_group' => 'condition_code','code' => '01','desc' => 'Military Service Related - This code indicates that the medical condition being treated was incurred during military service. Coordinate coverage with the Department of Veterans Affairs','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '542','code_group' => 'condition_code','code' => '02','desc' => 'Condition is employment related. Providers enter this code if the patient alleges that the medical condition causing this episode of care is due to environment/events resulting from employment.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '543','code_group' => 'condition_code','code' => '04','desc' => 'Patient is a member of a Medicare Advantage (MA) plan. Providers report this code for information only purposes to correctly report benefit period utilization to the Common Working File (CWF).','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '544','code_group' => 'condition_code','code' => '05','desc' => 'Lien has been filed. The provider has filed legal claim for recovery of funds potentially due to a patient as a result of legal action initiated by or on behalf of a patient.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '545','code_group' => 'condition_code','code' => '06','desc' => 'End Stage Renal Disease (ESRD) patient in the first 30 months of entitlement covered by employer group health insurance. Medicare may be a secondary insurer if the patient is also covered by an employer group health insurance during the patient\'s first 30 months of ESRD entitlement.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '546','code_group' => 'condition_code','code' => '07','desc' => 'Treatment of a non-terminal condition for a hospice patient. Report this code when the patient has elected hospice care, but the provider is not treating the patient for the terminal condition.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '547','code_group' => 'condition_code','code' => '08','desc' => 'Beneficiary would not provide information concerning other insurance coverage. The MAC develops to determine proper payment.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '548','code_group' => 'condition_code','code' => '09','desc' => 'Neither the patient nor the spouse is employed.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '549','code_group' => 'condition_code','code' => '10','desc' => 'Patient and/or spouse is employed but no Employee Group Health Plan (EGHP) coverage exists.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '550','code_group' => 'condition_code','code' => '11','desc' => 'Disabled beneficiary but no Large Group Health Plan (LGHP).','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '551','code_group' => 'condition_code','code' => '15','desc' => 'Clean claim delayed in CMS\' processing system. (Payer Only Code)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '552','code_group' => 'condition_code','code' => '16','desc' => 'Skilled Nursing Facility (SNF) transition exemption (Payer Only Code). An exemption from the post-hospital requirement applies for this SNF stay or the qualifying stay dates are more than 30 days prior to the admission date.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '553','code_group' => 'condition_code','code' => '20','desc' => 'Beneficiary requested billing. Provider determined services are part of a non-covered level of care or excluded, but beneficiary requests determination by payer. (Limited to home health and inpatient SNF claims.)','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '554','code_group' => 'condition_code','code' => '21','desc' => 'Billing for denial notice.Provider determined services are at a non-covered level or excluded, but it is requesting a denial notice from Medicare in order to bill Medicaid or other insurers.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '555','code_group' => 'condition_code','code' => '26','desc' => 'Veteran\'s Administration (VA) eligible patient chooses to receive services in a Medicare Certified Facility.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '556','code_group' => 'condition_code','code' => '27','desc' => 'Patient referred to a sole community hospital for a diagnostic laboratory test. (Sole Community Hospitals only). The provider uses this code to indicate laboratory service is paid at 62 percent fee schedule rather than 60 percent fee schedule.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '557','code_group' => 'condition_code','code' => '28','desc' => 'Patient\'s and/or spouse\'s EGHP is secondary to Medicare. In response to the Medicare Secondary Payer (MSP) questionnaire, the patient and/or spouse indicated that one or both are employed and that there is group health insurance from an EGHP or other employer-sponsored or provided health insurance that covers the patient but that either: the EGHP is a single employer plan and the employer has fewer than 20 full and part time employees; or the EGHP is a multiple employer plan that elects to pay secondary to Medicare for employees and spouses aged 65 and older for those participating employers who have fewer than 20 employees.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '558','code_group' => 'condition_code','code' => '29','desc' => 'Disabled beneficiary and/or family member\'s LGHP is secondary to Medicare. In response to the Medicare Secondary Payer (MSP) questionnaire, the patient and/or family member(s) indicated that one or more are employed and there is group health insurance from an LGHP or other employer-sponsored or provided health insurance that covers the patient but that either: the LGHP is a single employer plan and the employer has fewer than 100 full and part time employees; or the LGHP is a multiple employer plan and that all employers participating in the plan have fewer than 100 full and part-time employees.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '559','code_group' => 'condition_code','code' => '30','desc' => 'Non-research services provided to all patients, including managed care enrollees, enrolled in a Qualified Clinical Trial.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '560','code_group' => 'condition_code','code' => '31','desc' => 'Patient is a student (full time day).','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '561','code_group' => 'condition_code','code' => '32','desc' => 'Patient is a Student (Cooperative/Work Study Program).','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '562','code_group' => 'condition_code','code' => '33','desc' => 'Patient is a student (Full-Time Night).','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '563','code_group' => 'condition_code','code' => '34','desc' => 'Patient is student (Part-Time).','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '564','code_group' => 'condition_code','code' => '36','desc' => 'General care patient in a special unit. - (Not used by Prospective Payment System (PPS) hospitals) The hospital temporarily placed the patient in a special care unit because no general care beds were available. Accommodation charges for this period are at the prevalent semi-private rate.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '565','code_group' => 'condition_code','code' => '37','desc' => 'Ward accommodation at patient\'s request - Not used by PPS Hospitals.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '566','code_group' => 'condition_code','code' => '38','desc' => 'Semi-private room is not available. Not used by PPS Hospitals.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '567','code_group' => 'condition_code','code' => '39','desc' => 'Private room medically necessary. Not used by PPS Hospitals.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '568','code_group' => 'condition_code','code' => '40','desc' => 'Same day transfer. The patient was transferred to another participating Medicare provider before midnight on the day of admission.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '569','code_group' => 'condition_code','code' => '41','desc' => 'Claim is for partial outpatient hospitalization services which include a variety of psychiatric programs.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '570','code_group' => 'condition_code','code' => '42','desc' => 'Continued care plan is not related to the patient\'s inpatient admission condition or diagnosis.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '571','code_group' => 'condition_code','code' => '43','desc' => 'Continued care not provided within post discharge window','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '572','code_group' => 'condition_code','code' => '44','desc' => 'Inpatient admission changed to outpatient. –Code used on outpatient claims only, when the physician ordered inpatient services, but upon internal utilization review performed before the claim was originally submitted, the hospital determined that the services did not meet its inpatient criteria. The change in patient status from inpatient to outpatient is made prior to discharge or release while the patient is still a patient of the hospital.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '573','code_group' => 'condition_code','code' => '49','desc' => 'Product lifecycle replacement of a product earlier than the anticipated lifecycle due to an indication that the product is not functioning properly.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '574','code_group' => 'condition_code','code' => '50','desc' => 'Product replacement for known recall by a Product Manufacturer or FDA.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '575','code_group' => 'condition_code','code' => '51','desc' => 'Provider attestation of that services billed are unrelated outpatient non-diagnostic services which should not be bundled into the inpatient hospital claim.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '576','code_group' => 'condition_code','code' => '52','desc' => 'Hospice beneficiary moves out of service area.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '577','code_group' => 'condition_code','code' => '53','desc' => 'The initial placement of a medical device provided as part of a clinical trial or a free sample.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '578','code_group' => 'condition_code','code' => '55','desc' => 'SNF bed is not available. The patient\'s SNF admission was delayed more than 30 days after hospital discharge because a SNF bed was not available.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '579','code_group' => 'condition_code','code' => '56','desc' => 'Medical appropriateness condition code. Patient\'s SNF admission was delayed more than the 30 days after hospital discharge because the patient\'s condition made it inappropriate to begin active care within that period.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '580','code_group' => 'condition_code','code' => '57','desc' => 'SNF readmission when the patient previously received Medicare covered SNF care within 30 days of the current SNF admission.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '581','code_group' => 'condition_code','code' => '58','desc' => 'SNF patient terminated MA Plan enrollment. Providers report this code to waive 3-day qualifying stay requirement.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '582','code_group' => 'condition_code','code' => '59','desc' => 'Non-primary ESRD facility. Provider reports this code to indicate the ESRD beneficiary received non-scheduled or emergency dialysis services at a facility other than his/her primary ESRD dialysis facility.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '583','code_group' => 'condition_code','code' => '60','desc' => 'Operating cost day outlier. (Payer code only.)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '584','code_group' => 'condition_code','code' => '61','desc' => 'Operating cost outlier which is not reported by provider. Pricer indicates this bill is a cost outlier and MAC indicates the operating cost outlier portion paid in value code 17.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '585','code_group' => 'condition_code','code' => '62','desc' => 'PIP bill not reported by providers. Bill was paid under PIP and recorded by system.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '586','code_group' => 'condition_code','code' => '63','desc' => 'Bypass CWF edit for incarcerated beneficiaries. Services rendered to a prisoner or a patient in State or local custody (meets requirements of 42 CFR 411.4(b) for payment). Contractor use only.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '587','code_group' => 'condition_code','code' => '64','desc' => 'Other than clean claim.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '588','code_group' => 'condition_code','code' => '65','desc' => 'Non-PPS bill not reported by providers. MAC records this from system for non-PPS hospital bills.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '589','code_group' => 'condition_code','code' => '66','desc' => 'Hospital does not wish cost outlier payment. The hospital is not requesting additional payment for this stay as a cost outlier. (Only hospitals paid under PPS use this code.)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '590','code_group' => 'condition_code','code' => '67','desc' => 'Beneficiary elects not to use Lifetime Reserve (LTR) Days.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '591','code_group' => 'condition_code','code' => '68','desc' => 'Beneficiary elects to use Lifetime Reserve (LTR) Days.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '592','code_group' => 'condition_code','code' => '69','desc' => 'IME/DGME/N&A payment only billing.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '593','code_group' => 'condition_code','code' => '70','desc' => 'Self-administered erythropoetin alpha (EPO) . Code indicates the billing is for a home dialysis patient who self-administers EPO or darbopoetin alpha.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '594','code_group' => 'condition_code','code' => '71','desc' => 'Full care in unit. The billing is for a patient who received staff-assisted dialysis services in a hospital or renal dialysis facility.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '595','code_group' => 'condition_code','code' => '72','desc' => 'Self-Care in unit. The billing is for a patient who managed his/her own dialysis services without staff assistance in a hospital or renal dialysis facility.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '596','code_group' => 'condition_code','code' => '73','desc' => 'Self-Care training. The bill is for special dialysis services where a patient and his/her helper (if necessary) were learning to perform dialysis.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '597','code_group' => 'condition_code','code' => '74','desc' => 'The bill is for a patient who received dialysis services at home.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '598','code_group' => 'condition_code','code' => '76','desc' => 'Back-up dialysis in-facility The bill is for a home dialysis patient who received back-up dialysis in a facility.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '599','code_group' => 'condition_code','code' => '77','desc' => 'Provider accepts or is obligated/required due to contractual arrangement or law to accept payment by a primary payer as payment in full','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '600','code_group' => 'condition_code','code' => '78','desc' => 'Newly covered Medicare service for which an HMO doesn\'t pay. For outpatient bills, condition code 04 should be omitted.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '601','code_group' => 'condition_code','code' => '79','desc' => 'Comprehensive Outpatient Rehabilitation Facilities (CORF) services provided off-site. Physical therapy, occupational therapy, or speech pathology services were provided offsite.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '602','code_group' => 'condition_code','code' => '81','desc' => 'C-sections or inductions performed at less than 39 weeks gestation for medical necessity.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '603','code_group' => 'condition_code','code' => '82','desc' => 'C-sections or inductions performed at less than 39 weeks gestation electively.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '604','code_group' => 'condition_code','code' => '83','desc' => 'C-sections or inductions performed at 39 weeks gestation or greater.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '605','code_group' => 'condition_code','code' => '84','desc' => 'Dialysis for Acute Kidney Injury (AKI) on monthly basis','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '606','code_group' => 'condition_code','code' => '88','desc' => 'Medicaid birth weights.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '607','code_group' => 'condition_code','code' => '98','desc' => 'Data associated with diagnosis-related grouper (DRG) 468 has been validated.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '608','code_group' => 'condition_code','code' => 'G0','desc' => 'Distinct medical visit. Multiple medical visits/evaluation and management visits occurred on the same day in the same revenue center and the visits were distinct and constituted independent visits. Not reported by CAHs.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '609','code_group' => 'condition_code','code' => 'H0','desc' => 'Delayed filing, statement of intent submitted within the qualified period to specifically identify the existence of another third party liability situation.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '610','code_group' => 'condition_code','code' => 'A0','desc' => 'Special ambulance zip code reporting.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '611','code_group' => 'condition_code','code' => 'A3','desc' => 'Special Federal Funding','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '612','code_group' => 'condition_code','code' => 'A5','desc' => 'Disability','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '613','code_group' => 'condition_code','code' => 'A6','desc' => 'Medicare pneumococcal pneumococcal or influenza paid at 100%.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '614','code_group' => 'condition_code','code' => 'A7','desc' => 'Induced Abortion due to danger to life.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '615','code_group' => 'condition_code','code' => 'A9','desc' => 'Second opinion for surgery.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '616','code_group' => 'condition_code','code' => 'AA','desc' => 'Abortion performed due to rape.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '617','code_group' => 'condition_code','code' => 'AB','desc' => 'Abortion performed due to incest.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '618','code_group' => 'condition_code','code' => 'AC','desc' => 'Abortion performed due to serious fetal genetic defect, deformity, abnormality0','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '619','code_group' => 'condition_code','code' => 'AD','desc' => 'Abortion performed due to life endangering physical condition caused by, arising from or exacerbated by the pregnancy itself.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '620','code_group' => 'condition_code','code' => 'AE','desc' => 'Abortion performed due to physical health of mother that is not life endangering.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '621','code_group' => 'condition_code','code' => 'AF','desc' => 'Abortion performed due to emotional/psychological health of mother.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '622','code_group' => 'condition_code','code' => 'AG','desc' => 'Abortion performed due to social economic reasons.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '623','code_group' => 'condition_code','code' => 'AH','desc' => 'Elective abortion.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '624','code_group' => 'condition_code','code' => 'AI','desc' => 'Sterilization','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '625','code_group' => 'condition_code','code' => 'AJ','desc' => 'Payer responsible for co-payment.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '626','code_group' => 'condition_code','code' => 'AK','desc' => 'Air ambulance required.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '627','code_group' => 'condition_code','code' => 'AL','desc' => 'Specialized treatment/bed unavailable.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '628','code_group' => 'condition_code','code' => 'AM','desc' => 'Non-emergency medically necessary stretcher transport required.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '629','code_group' => 'condition_code','code' => 'B0','desc' => 'Medicare Coordinated Care Demonstration Program (MCCD).','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '630','code_group' => 'condition_code','code' => 'B1','desc' => 'Beneficiary is ineligible for Full Demonstration Program.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '631','code_group' => 'condition_code','code' => 'B2','desc' => 'Critical Access Hospital ambulance attestation that it meets the criteria for exemption from the ambulance fee schedule.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '632','code_group' => 'condition_code','code' => 'B3','desc' => 'Pregnancy indicator.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '633','code_group' => 'condition_code','code' => 'EY','desc' => 'Lung reduction study demonstration claims, set demo code 30.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '634','code_group' => 'condition_code','code' => 'MG','desc' => 'Grandfathered Tribal Federally Qualified Health Centers.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '635','code_group' => 'condition_code','code' => 'M0','desc' => 'All-Inclusive rate for outpatient services.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '636','code_group' => 'condition_code','code' => 'M1','desc' => 'Roster billed influenza virus vaccine or pneumococcal pneumonia vaccine (PPV).','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '637','code_group' => 'condition_code','code' => 'W0','desc' => 'United Mine Workers of America demonstration indicator.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '638','code_group' => 'condition_code','code' => 'QI','desc' => 'Approval','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '639','code_group' => 'condition_code','code' => 'C1','desc' => 'Approved as billed.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '640','code_group' => 'condition_code','code' => 'C3','desc' => 'Partial approval.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '641','code_group' => 'condition_code','code' => 'C4','desc' => 'Admission denied.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '642','code_group' => 'condition_code','code' => 'C5','desc' => 'Post payment review applicable.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '643','code_group' => 'condition_code','code' => 'C6','desc' => 'Pre-admission/pre-procedure authorized but QIO has not reviewed service(s) provided.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '644','code_group' => 'condition_code','code' => 'C7','desc' => 'Extended authorization authorized but QIO has not reviewed service(s) provided.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '645','code_group' => 'condition_code','code' => 'R1','desc' => 'Mathematical or computational mistakes.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '646','code_group' => 'condition_code','code' => 'R2','desc' => 'Inaccurate data entry, for example miskeyed or transposed provider number, referring NPI, date of service, procedure code, etc.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '647','code_group' => 'condition_code','code' => 'R3','desc' => 'Misapplication of a fee schedule.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '648','code_group' => 'condition_code','code' => 'R4','desc' => 'Computer errors.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '649','code_group' => 'condition_code','code' => 'R5','desc' => 'Duplicate claim which the party believes were incorrectly identified as duplicate.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '650','code_group' => 'condition_code','code' => 'R6','desc' => 'Other clerical errors or minor errors and omissions not specified in R1-R5.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '651','code_group' => 'condition_code','code' => 'R7','desc' => 'Claim corrections other than clerical errors within one year of the date of initial determination.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '652','code_group' => 'condition_code','code' => 'R8','desc' => 'A reopening for good cause (one to four years from the date of the initial determination) due to new and material evidence that was not available or known at the time of the determination or decision and may result in a different conclusion.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '653','code_group' => 'condition_code','code' => 'R9','desc' => 'A reopening for good cause (one to four years from the date of initial determination) because the evidence that was considered in making the determination or decision clearly shows that an obvious error was made at the time of the determination or decision.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '654','code_group' => 'patient_status_code','code' => '01','desc' => 'Discharged to home or self care; jail or law enforcement; group home, foster care, & other residential care arrangements; Outpatient programs e.g. partial hospitalization, OP chemical dependency programs; assisted living facilities that are not state designated (routine discharge)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '655','code_group' => 'patient_status_code','code' => '02','desc' => 'Discharged/transferred to short-term general hospital for Inpatient Care','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '656','code_group' => 'patient_status_code','code' => '03','desc' => 'Discharged/transferred to SNF with Medicare certification in anticipation of covered skilled care. Do not use this for transfers to a non-Medicare certified area. For Swing Beds see Code 61 below','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '657','code_group' => 'patient_status_code','code' => '04','desc' => 'Discharged/transferred to an Intermediate Care Facility e.g. non-certified SNF beds, State designated Assisted Living Facilities','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '658','code_group' => 'patient_status_code','code' => '05','desc' => 'Discharged/transferred to a designated cancer center or children\'s hospital','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '659','code_group' => 'patient_status_code','code' => '06','desc' => 'Discharged/transferred to home under care of organized home health service organization in anticipation of covered skilled care. Dsch/Trans to home with written plan of care, foster care facility with home care & under home health agency with DME','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '660','code_group' => 'patient_status_code','code' => '07','desc' => 'Left against medical advice or discontinued care. Patients who leave before triage or seen by physician','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '661','code_group' => 'patient_status_code','code' => '09','desc' => 'Admitted as an inpatient to this hospital-only use on Medicare OP claims when services begin when those Medicare OP services are greater than 3 days prior to an admission','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '662','code_group' => 'patient_status_code','code' => '20','desc' => 'Expired -used only when the patient dies','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '663','code_group' => 'patient_status_code','code' => '21','desc' => 'Discharges or transfers to court/law enforcement; includes transfers to incarceration facilities such as jail, prison or other detention facilities. Effective 10/1/09','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '664','code_group' => 'patient_status_code','code' => '30','desc' => 'Still a patient or expected to return for outpatient services-used when billing for LOA days or interim bills. It can be used for both IP or OP claims, for IP claims the claim needs to be greater than 60 days','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '665','code_group' => 'patient_status_code','code' => '40','desc' => 'Expired at home (Hospice claims only) used only on Medicare and TRICARE claims for hospice care','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '666','code_group' => 'patient_status_code','code' => '41','desc' => 'Expired in a medical facility (hospital, SNF, Intermediate Care Facility, or free standing hospice) for hospice use only','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '667','code_group' => 'patient_status_code','code' => '42','desc' => 'Expired - place unknown -this is used only on Medicare and TRICARE claims for Hospice only','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '668','code_group' => 'patient_status_code','code' => '43','desc' => 'Discharged/transferred to a Federal hospital Dept of Defense hospitals, VA hospitals, VA Psych unit or VA nursing facilities','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '669','code_group' => 'patient_status_code','code' => '50','desc' => 'Discharged/transferred to Hospice (home)-or alternative setting that is the patient\'s home such as nursing facility, and will receive in-home hospice services','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '670','code_group' => 'patient_status_code','code' => '51','desc' => 'Discharged/transferred to Hospice medical facility- patient went to an IP facility that is qualified and the patient is to receive the general IP hospice level of care or hospice respite care. Used also if the patient is discharged from an IP acute care hospital to remain in hospital under hospice care','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '671','code_group' => 'patient_status_code','code' => '61','desc' => 'Discharged/transferred within this institution to a hospital based Medicare approved swing bed. This is also used when discharged from an acute care hospital to a CAH swing bed','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '672','code_group' => 'patient_status_code','code' => '62','desc' => 'Discharged/transferred to an inpatient rehabilitation facility including distinct part units of a hospital','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '673','code_group' => 'patient_status_code','code' => '63','desc' => 'Discharged/transferred to a long term care hospital','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '674','code_group' => 'patient_status_code','code' => '64','desc' => 'Discharged/transferred to a nursing facility certified under Medicaid but not certified under Medicare. If the facility has some Medicare certified beds you should use patient status code 03 or 04 depending on the level of care the patient is receiving and if they are placed in a Medicare certified bed or not','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '675','code_group' => 'patient_status_code','code' => '65','desc' => 'Discharged/transferred to a psychiatric hospital or psychiatric distinct part unit of a hospital','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '676','code_group' => 'patient_status_code','code' => '66','desc' => 'Discharged/transferred to a Critical Access Hospital (CAH)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '677','code_group' => 'patient_status_code','code' => '69','desc' => 'Discharged/transferred to a designated disaster alternative care site','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '678','code_group' => 'patient_status_code','code' => '70','desc' => 'Discharged/transferred to another type of health care institution not defined elsewhere in the code list','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '679','code_group' => 'patient_status_code','code' => '81','desc' => 'Discharged to home or self-care with a planned acute care hospital inpatient readmission','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '680','code_group' => 'patient_status_code','code' => '82','desc' => 'Discharged/transferred to a short term general hospital for inpatient care with a planned acute care hospital inpatient readmission','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '681','code_group' => 'patient_status_code','code' => '83','desc' => 'Discharged/transferred to a skilled nursing facility (SNF) with Medicare certification with a planned acute care hospital inpatient readmission','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '682','code_group' => 'patient_status_code','code' => '84','desc' => 'Discharged/transferred to a facility that provides custodial or supportive care with a planned acute care hospital inpatient readmission','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '683','code_group' => 'patient_status_code','code' => '85','desc' => 'Discharged/transferred to a designated cancer center or children\'s hospital with a planned acute care hospital inpatient readmission','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '684','code_group' => 'patient_status_code','code' => '86','desc' => 'Discharged/transferred to home under care of organized home health service organization with a planned acute care hospital inpatient readmission','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '685','code_group' => 'patient_status_code','code' => '87','desc' => 'Discharged/transferred to court/law enforcement with a planned acute care hospital inpatient readmission','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '686','code_group' => 'patient_status_code','code' => '88','desc' => 'Discharged/transferred to a federal health care facility with a planned acute care hospital inpatient readmission','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '687','code_group' => 'patient_status_code','code' => '89','desc' => 'Discharged/transferred to a hospital-based Medicare approved swing bed with a planned acute care hospital inpatient readmission','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '688','code_group' => 'patient_status_code','code' => '90','desc' => 'Discharged/transferred to an inpatient rehabilitation facility (IRF) including rehabilitation distinct part units of a hospital with a planned acute care hospital inpatient readmission','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '689','code_group' => 'patient_status_code','code' => '91','desc' => 'Discharged/transferred to a Medicare certified long term care hospital (LTCH) with a planned acute care hospital inpatient readmission','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '690','code_group' => 'patient_status_code','code' => '92','desc' => 'Discharged/transferred to a nursing facility certified under Medicaid but not certified under Medicare with a planned acute care hospital inpatient readmission','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '691','code_group' => 'patient_status_code','code' => '93','desc' => 'Discharged/transferred to a psychiatric distinct part unit of a hospital with a planned acute care hospital inpatient readmission','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '692','code_group' => 'patient_status_code','code' => '94','desc' => 'Discharged/transferred to a critical access hospital (CAH) with a planned acute care hospital inpatient readmission','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '693','code_group' => 'patient_status_code','code' => '95','desc' => 'Discharged/transferred to another type of health care institution not defined elsewhere in this code list with a planned acute care hospital inpatient readmission','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '694','code_group' => 'occurrence_span_code','code' => '70','desc' => 'Qualifying Stay Dates - SNF TOB 3-day hospital stay qualifying stay dates for SNF use only.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '695','code_group' => 'occurrence_span_code','code' => '70','desc' => '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.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '696','code_group' => 'occurrence_span_code','code' => '71','desc' => '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.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '697','code_group' => 'occurrence_span_code','code' => '72','desc' => '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.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '698','code_group' => 'occurrence_span_code','code' => '74','desc' => '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.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '699','code_group' => 'occurrence_span_code','code' => '75','desc' => '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.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '700','code_group' => 'occurrence_span_code','code' => '76','desc' => 'Patient Liability-From/through dates of a period of non-covered care for which the hospital/ SNF is permitted to charge the Medicare beneficiary.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '701','code_group' => 'occurrence_span_code','code' => '77','desc' => 'Provider Liability-Utilization Charged - The from/through dates of a period of non-covered care for which the provider is liable','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '702','code_group' => 'occurrence_span_code','code' => '78','desc' => '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','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '703','code_group' => 'occurrence_span_code','code' => '79','desc' => 'Payer Code - THIS CODE IS SET ASIDE FOR PAYER USE ONLY. PROVIDERS DO NOT REPORT THIS CODE.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '704','code_group' => 'occurrence_span_code','code' => 'M0','desc' => '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.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '705','code_group' => 'occurrence_span_code','code' => 'M1','desc' => '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.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '706','code_group' => 'occurrence_span_code','code' => 'M2','desc' => 'Dates of Inpatient Respite Care for hospice patients','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '707','code_group' => 'occurrence_span_code','code' => 'M3','desc' => 'ICF Level of Care - From/through dates of a period of intermediate level of care during an inpatient hospital stay','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '708','code_group' => 'occurrence_span_code','code' => 'M4','desc' => 'Residential Level of Care - From/through dates of period of residential level of care during an inpatient stay','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '709','code_group' => 'occurrence_code','code' => '1','desc' => 'Accident/Medical Coverage - Code indicating accident-related injury for which there is medical payment coverage. Provide the date of accident/injury','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '710','code_group' => 'occurrence_code','code' => '2','desc' => 'No-Fault Insurance Involved-including auto accident/other - Date of an accident, including auto or other, where the State has applicable no-fault or liability laws (i.e., legal basis for settlement without admission or proof of guilt).','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '711','code_group' => 'occurrence_code','code' => '3','desc' => 'Accident/TORT liability - Date of an accident resulting from a third party\'s action that may involve a civil court action in an attempt to require payment by the third party, other than no-fault liability.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '712','code_group' => 'occurrence_code','code' => '4','desc' => 'Accident/employment related','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '713','code_group' => 'occurrence_code','code' => '5','desc' => 'Accident/No medical or liability coverage - Code indicating accident related injury for which there is no medical payment or third-party liability coverage. Provide date of accident or injury.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '714','code_group' => 'occurrence_code','code' => '6','desc' => 'Crime Victim','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '715','code_group' => 'occurrence_code','code' => '8','desc' => 'Reserved for National Assignment','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '716','code_group' => 'occurrence_code','code' => '9','desc' => 'Start of infertility treatment Cycle','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '717','code_group' => 'occurrence_code','code' => '10','desc' => 'Last menstrual period','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '718','code_group' => 'occurrence_code','code' => '11','desc' => 'Onset of Symptoms/Illness - (outpatient claims only). If beneficiary receiving a combination of PT/OT/SLP only one 11 occurrence code is required','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '719','code_group' => 'occurrence_code','code' => '12','desc' => 'Date of Onset for a Chronically Dependent Individual (CDI)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '720','code_group' => 'occurrence_code','code' => '16','desc' => 'Date of last therapy - Code indicates the last day of therapy services (e.g., physical, occupational or speech therapy).','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '721','code_group' => 'occurrence_code','code' => '17','desc' => 'Date occupational therapy plan established or last reviewed','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '722','code_group' => 'occurrence_code','code' => '18','desc' => 'Date of patient/beneficiary retirement','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '723','code_group' => 'occurrence_code','code' => '19','desc' => 'Date of retirement of spouse','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '724','code_group' => 'occurrence_code','code' => '20','desc' => 'Guarantee of Payment Began-(Part A hospital claims only)-date hospital begins claiming payment.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '725','code_group' => 'occurrence_code','code' => '21','desc' => 'UR Notice Received (Part A SNF Claims Only) - date of receipt by the SNF and hospital of URC finding an admission or further stay was not medically necessary.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '726','code_group' => 'occurrence_code','code' => '22','desc' => 'Date Active Care Ended - date a covered level of care ended in SNF or general hospital or date active care ended in psych or tuberculosis hospital or date patient was released on trial basis from residential facility. *Code not required if code 21 is used.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '727','code_group' => 'occurrence_code','code' => '23','desc' => 'Date of Cancellation of Hospice Election Period. For FI Use Only. Providers Do Not Report. *Not required if code 21 is used.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '728','code_group' => 'occurrence_code','code' => '24','desc' => 'Date insurance denied','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '729','code_group' => 'occurrence_code','code' => '25','desc' => 'Date coverage benefits are terminated by primary payer.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '730','code_group' => 'occurrence_code','code' => '26','desc' => 'Date SNF bed available to the Inpatient who requires only SNF level care','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '731','code_group' => 'occurrence_code','code' => '27','desc' => 'Date of Hospice Certification or re-certification','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '732','code_group' => 'occurrence_code','code' => '28','desc' => 'Date CORF Plan established or last reviewed','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '733','code_group' => 'occurrence_code','code' => '29','desc' => 'Date outpatient physical therapy plan established or last reviewed','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '734','code_group' => 'occurrence_code','code' => '30','desc' => 'Date outpatient speech language pathology plan established or last reviewed','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '735','code_group' => 'occurrence_code','code' => '31','desc' => 'Date beneficiary notified of intent to bill (accommodations) - beneficiary does not (or no longer) require covered level of inpatient care.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '736','code_group' => 'occurrence_code','code' => '32','desc' => 'Date beneficiary notified of intent to bill (diagnostic procedures or treatment) is not reasonable or necessary under Medicare','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '737','code_group' => 'occurrence_code','code' => '33','desc' => 'First day of the Medicare Coordination Period for ESRD Beneficiaries covered by an EGHP. Required only for ESRD beneficiaries.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '738','code_group' => 'occurrence_code','code' => '34','desc' => 'Date of the election of extended care services (used by Religious Nonmedical Health Care Institutions ONLY)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '739','code_group' => 'occurrence_code','code' => '35','desc' => 'Date physical therapy treatment started','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '740','code_group' => 'occurrence_code','code' => '36','desc' => 'Date of Inpatient hospital discharge for a covered transplant procedure(s). NOTE: When patient received a covered and non-covered transplant, the covered transplant predominates.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '741','code_group' => 'occurrence_code','code' => '37','desc' => 'Date of Inpatient hospital discharge - patient received a non-covered transplant','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '742','code_group' => 'occurrence_code','code' => '38','desc' => 'Date treatment started for Home IV Therapy','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '743','code_group' => 'occurrence_code','code' => '39','desc' => 'Date discharged on a continuous course of IV therapy','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '744','code_group' => 'occurrence_code','code' => '40','desc' => 'Scheduled date of Admission (this code may only be used on an outpatient claim)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '745','code_group' => 'occurrence_code','code' => '41','desc' => 'Date of First Test for Pre-admission Testing (this code may be used only if date of admission was scheduled prior to administration of test(s))','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '746','code_group' => 'occurrence_code','code' => '42','desc' => 'Hospice discharge due to patient revocation','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '747','code_group' => 'occurrence_code','code' => '43','desc' => 'Scheduled date of Cancelled Surgery','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '748','code_group' => 'occurrence_code','code' => '44','desc' => 'Date treatment started for occupational therapy','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '749','code_group' => 'occurrence_code','code' => '45','desc' => 'Date treatment started for speech-language pathology','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '750','code_group' => 'occurrence_code','code' => '46','desc' => 'Date treatment started for cardiac rehabilitation','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '751','code_group' => 'occurrence_code','code' => '47','desc' => 'Date cost outlier status begins, beneficiary must have regular coinsurance and/or lifetime reserve days available beginning on this date to allow coverage of additional daily charges to receive cost outlier payments','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '752','code_group' => 'occurrence_code','code' => '48','desc' => 'Payer Codes - for use by third party payers only. The CMS assigns for FI use. Providers do not report these codes.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '753','code_group' => 'occurrence_code','code' => '49','desc' => 'Payer Codes - for use by third party payers only. The CMS assigns for FI use. Providers do not report these codes.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '754','code_group' => 'occurrence_code','code' => '50','desc' => 'Assessment Date for IRF, SNF and SB PPS Note: Not required for SNF HIPPS code AAAxx','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '755','code_group' => 'occurrence_code','code' => '51','desc' => 'Date of last Kt/V reading','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '756','code_group' => 'occurrence_code','code' => '55','desc' => 'Date of Death','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '757','code_group' => 'occurrence_code','code' => 'A1','desc' => 'Birth Date Insured A - birth date of insured in whose name the insurance is carried.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '758','code_group' => 'occurrence_code','code' => 'A2','desc' => 'Effective Date-Insured A Policy - first date insurance is in force.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '759','code_group' => 'occurrence_code','code' => 'A3','desc' => 'Benefits Exhausted - last date benefits are available and no payment can be made by Payer A.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '760','code_group' => 'occurrence_code','code' => 'A4','desc' => 'Split Bill Date (date patient became Medicaid eligible due to medically needy spend down)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '761','code_group' => 'occurrence_code','code' => 'B1','desc' => 'Birth Date - Insured B','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '762','code_group' => 'occurrence_code','code' => 'B2','desc' => 'Effective Date-Insured B Policy','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '763','code_group' => 'occurrence_code','code' => 'B3','desc' => 'Benefits Exhausted','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '764','code_group' => 'occurrence_code','code' => 'C1','desc' => 'Birth Date-Insured C','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '765','code_group' => 'occurrence_code','code' => 'C2','desc' => 'Effective Date-Insured C Policy','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '766','code_group' => 'occurrence_code','code' => 'C3','desc' => 'Benefits Exhausted','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '767','code_group' => 'occurrence_code','code' => 'E1','desc' => 'Birthdate-Insured D','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '768','code_group' => 'occurrence_code','code' => 'E2','desc' => 'Effective Date-Insured D Policy','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '769','code_group' => 'occurrence_code','code' => 'E3','desc' => 'Benefits Exhausted','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '770','code_group' => 'occurrence_code','code' => 'F0','desc' => 'Reserved for National Assignment','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '771','code_group' => 'occurrence_code','code' => 'F1','desc' => 'Birthdate-Insured E','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '772','code_group' => 'occurrence_code','code' => 'F2','desc' => 'Effective Date-Insured E Policy','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '773','code_group' => 'occurrence_code','code' => 'F3','desc' => 'Benefits Exhausted','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '774','code_group' => 'occurrence_code','code' => 'G0','desc' => 'Reserved for National Assignment','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '775','code_group' => 'occurrence_code','code' => 'G1','desc' => 'Birthdate-Insured F','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '776','code_group' => 'occurrence_code','code' => 'G2','desc' => 'Effective Date-Insured F Policy','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '777','code_group' => 'occurrence_code','code' => 'G3','desc' => 'Benefits Exhausted','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '778','code_group' => 'occurrence_code','code' => 'M0','desc' => 'See Instructions in Form Locator 36-Occurrence Span Codes and Dates','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '779','code_group' => 'occurrence_code','code' => 'ZZ','desc' => 'See Instructions in Form Locator 36-Occurrence Span Codes and Dates','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '780','code_group' => 'value_codes','code' => '01','desc' => 'Most common Semi-Private Rate - to provide for recording hospital\'s most common semi- private rate.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '781','code_group' => 'value_codes','code' => '02','desc' => 'Hospital has no semi-private rooms - using this code requires $0.00 amount.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '782','code_group' => 'value_codes','code' => '04','desc' => 'Inpatient Professional Component Charges Which Are Combined Billed - (Used only by some all- inclusive rate hospitals)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '783','code_group' => 'value_codes','code' => '05','desc' => 'Professional component included in charges and billed separately to carrier - (Applies to Part B bills only)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '784','code_group' => 'value_codes','code' => '06','desc' => 'Medicare Part A and Part B Blood Deductible for un-replaced deductible pints of blood supplied times the charge per pint. If all deductible pints have been replaced this code is not used','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '785','code_group' => 'value_codes','code' => '07','desc' => 'Reserved for National Assignment','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '786','code_group' => 'value_codes','code' => '08','desc' => 'Medicare Lifetime Reserve Amount in the First Calendar Year in Billing Period','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '787','code_group' => 'value_codes','code' => '09','desc' => 'Medicare Coinsurance Amount in the First Calendar Year in Billing Period','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '788','code_group' => 'value_codes','code' => '10','desc' => 'Medicare Lifetime Reserve Amount in the Second Calendar Year in Billing Period','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '789','code_group' => 'value_codes','code' => '11','desc' => 'Medicare Coinsurance Amount in the Second Calendar Year in Billing Period','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '790','code_group' => 'value_codes','code' => '12','desc' => 'Working Aged Beneficiary Spouse With an EGHP (Payer Code A)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '791','code_group' => 'value_codes','code' => '13','desc' => 'ESRD Beneficiary in Medicare Coordination Period','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '792','code_group' => 'value_codes','code' => '14','desc' => 'No-fault, including Auto/other liability insurance (Payer Code D). Enter 6 zeros (0000.00) in the amt field if claiming conditional pay because other insurer has denied coverage and there has been a substantial delay in payment','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '793','code_group' => 'value_codes','code' => '15','desc' => 'Worker\'s compensation (WC) (Payer Code E). Enter 6 zeros (0000.00) in the amt field if claiming conditional pay because there has been a substantial delay in payment.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '794','code_group' => 'value_codes','code' => '16','desc' => 'PHS or other federal agency (Payer Code F). Enter 6 zeros (0000.00) in the amt field if claiming conditional pay because there has been a significant delay in payment','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '795','code_group' => 'value_codes','code' => '17','desc' => 'Operating Outlier Amount (Not reported by providers)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '796','code_group' => 'value_codes','code' => '18','desc' => 'Operating Disproportionate Share Amount (Not reported by providers)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '797','code_group' => 'value_codes','code' => '19','desc' => 'Operating Indirect medical education on Unibill (IME) (Not reported by providers)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '798','code_group' => 'value_codes','code' => '20','desc' => 'Payer Code (For internal use by third party payers only)','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '799','code_group' => 'value_codes','code' => '23','desc' => 'Recurring Monthly Income - Medicaid-eligibility requirements to be determined at state level.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '800','code_group' => 'value_codes','code' => '31','desc' => 'Patient liability amount for non-covered services - FI approved the provider charging the beneficiary the amount shown for non-covered accommodations, diagnostic procedures, or treatments.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '801','code_group' => 'value_codes','code' => '32','desc' => 'Multiple Patient Ambulance transport - If more than one patient is transported in a single ambulance trip, report the total number of patients transported.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '802','code_group' => 'value_codes','code' => '36','desc' => 'Reserved for National Assignment','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '803','code_group' => 'value_codes','code' => '37','desc' => 'Pints of Blood Furnished - Total number of pints of whole blood or units of packed red cells furnished, whether or not they were replaced.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '804','code_group' => 'value_codes','code' => '38','desc' => 'Blood Deductible Pints - Number of unreplaced deductible pints of blood supplied. If all deductible pints furnished have been replaced, no entry is made.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '805','code_group' => 'value_codes','code' => '39','desc' => 'Pints of Blood Replaced Total number of pints of blood donated on patient\'s behalf','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '806','code_group' => 'value_codes','code' => '40','desc' => 'New Coverage Not Implemented by HMO (For inpatient service only) Inpatient charges for newly covered services not paid by the HMO. Must also report condition codes 04 and 78','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '807','code_group' => 'value_codes','code' => '41','desc' => 'Black Lung (Payer Code H) - Portion of a higher priority BL payment made on behalf of a Medicare beneficiary that the provider is applying to Medicare charges on the bill. It enters six zeros (0000.00) in the amount field if it\'s billing conditionally for substantially delayed payment.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '808','code_group' => 'value_codes','code' => '42','desc' => 'Veterans Affairs (VA) (Payer Code I) - Portion of a higher priority VA payment made on behalf of a Medicare beneficiary that the provider is applying to Medicare charges on the bill','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '809','code_group' => 'value_codes','code' => '43','desc' => 'Disabled beneficiary under 65 with LGHP (Payer Code G) - Portion of a higher priority LGHP payment made on behalf of a Medicare beneficiary that the provider is applying to Medicare charges on the bill. It enters six zeros (0000.00) in the amount field if it\'s billing conditionally for substantially delayed payment.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '810','code_group' => 'value_codes','code' => '44','desc' => 'Amount provider agreed to accept from primary payer when amount is < charges but higher than payment received - A Medicare secondary payment is due.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '811','code_group' => 'value_codes','code' => '45','desc' => 'Accident hour','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '812','code_group' => 'value_codes','code' => '46','desc' => 'Number of grace days following QIO/UR determination If C3 or C4 condition code is on the claim for QIO denial provider shows the number of days determined by the QIO to be covered while arrangements are made for the patient\'s post discharge. The field contains 1 numeric digit.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '813','code_group' => 'value_codes','code' => '47','desc' => 'Any liability insurance (Payer Code L) - Portion of a higher priority liability insurance payment made on behalf of a Medicare beneficiary that the provider is applying to Medicare charges on the bill. It enters six zeros (0000.00) in the amount field if it\'s billing conditionally for substantially delayed payment.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '814','code_group' => 'value_codes','code' => '48','desc' => 'Latest Hemoglobin reading taken during this billing cycle - Patients most recent hemoglobin reading taken before the start of the billing period effective 1/1/06. For patients just starting, use the most recent value prior to the onset of treatment. Whole numbers (i.e. two digits) are to be right justified to the left of the dollar/cents delimiter. Decimals (i.e. one digit) are to be reported to the right.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '815','code_group' => 'value_codes','code' => '49','desc' => 'Hematocrit reading taken prior to the last administration of EPO during the billing cycle - The most recent hematocrit reading taken before the start of this billing period. For patients just starting, use the most recent value prior to the onset of treatment. Whole numbers (i.e. two digits) are to be right justified to the left of the dollar/cents delimiter. Decimals (i.e. one digit) are to be reported to the right.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '816','code_group' => 'value_codes','code' => '54','desc' => 'Newborn birth weight in grams - Actual birth weight or weight at the time of admission for extramural birth','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '817','code_group' => 'value_codes','code' => '55','desc' => 'Eligibility Threshold for Charity Care - Corresponding value amount the health care facility determines eligibility threshold for charity care','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '818','code_group' => 'value_codes','code' => '56','desc' => 'Skilled Nurse--Home visit hours (HHA only) - Number of hours provided during billing period','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '819','code_group' => 'value_codes','code' => '57','desc' => 'Home Health Aide--Home visit hours (HHA only) - Number of hours provided during the billing period','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '820','code_group' => 'value_codes','code' => '58','desc' => 'Arterial Blood Gas (PO2/PA2) - Indicates arterial blood gas value at the beginning of each reporting period for oxygen therapy. This value or value 59 is required on the initial bill for oxygen therapy and on the fourth month\'s bill. The provider reports right justified in the cents area. Round to nearest whole percentage, i.e., report 56.5 as 57 to the right of the cents delimiter.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '821','code_group' => 'value_codes','code' => '59','desc' => 'Oxygen Saturation(02 Sat/Oximetry) - Indicates oxygen saturation at the beginning of each reporting period for oxygen therapy. This value or value 58 is required on the initial bill for oxygen therapy and on the fourth month\'s bill. The hospital reports right justified in the cents area. Round to nearest whole percentage, i.e., report 56.5 as 57 to the right of the cents delimiter.','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '822','code_group' => 'value_codes','code' => '60','desc' => 'HHA Branch MSA - The MSA in which the HHA branch is located','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '823','code_group' => 'value_codes','code' => '61','desc' => 'Location Where Service is Furnished (HHA and Hospice) - MSA number (or rural state code) of the location where the home health/hospice service is delivered','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '824','code_group' => 'value_codes','code' => '62','desc' => 'HH Visits - Part A (Internal Payer Use Only)','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '825','code_group' => 'value_codes','code' => '63','desc' => 'HH Visits - Part B (Internal Payer Use Only)','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '826','code_group' => 'value_codes','code' => '64','desc' => 'HH Reimbursement - Part A (Internal Payer Only) Dollar amounts determined to be associated with HH visits in value code 62','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '827','code_group' => 'value_codes','code' => '65','desc' => 'HH Reimbursement - Part B (Internal Payer Only) Dollar amounts determined to be associated with HH visits in value code 63','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '828','code_group' => 'value_codes','code' => '66','desc' => 'Medicare spend down amount - Dollar amount used to meet recipient\'s spend down liability','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '829','code_group' => 'value_codes','code' => '67','desc' => 'Peritoneal Dialysis Number of hours provided during billing period','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '830','code_group' => 'value_codes','code' => '68','desc' => 'Number of units of EPO administered and or supplied during the billing period - Number of units of EPO administered and/or supplied relating or billing period','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '831','code_group' => 'value_codes','code' => '69','desc' => 'State Charity Care Percent - Percentage of charity care eligibility for patient.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '832','code_group' => 'value_codes','code' => '70','desc' => 'Interest Amount (For use by third party payers only)','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '833','code_group' => 'value_codes','code' => '71','desc' => 'Funding of ESRD Networks - (For use by third party payers only)','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '834','code_group' => 'value_codes','code' => '72','desc' => 'Flat Rate Surgery Charge - (For use by third party payers only) Standard charge for outpatient surgery','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '835','code_group' => 'value_codes','code' => '76','desc' => 'Provider\'s interim rate (set internally) - (For use by third party payers only)','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '836','code_group' => 'value_codes','code' => '77','desc' => 'Medicare new technology add-on payment - Code indicates the amount of Medicare additional payment for new technology.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '837','code_group' => 'value_codes','code' => '80','desc' => 'Covered Days - Effective 03/01/07 Hardcopy UB04 Claims','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '838','code_group' => 'value_codes','code' => '81','desc' => 'Non-Covered Days - Effective 03/01/07 Hardcopy UB04 Claims','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '839','code_group' => 'value_codes','code' => '82','desc' => 'Coinsurance Days - Effective 03/01/07 Hardcopy UB04 Claims','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '840','code_group' => 'value_codes','code' => '83','desc' => 'Lifetime Reserve Days - Effective 03/01/07 Hardcopy UB04 Claims','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '841','code_group' => 'value_codes','code' => 'A0','desc' => 'Special Zip Code Reporting - 5 digit zip code of location the beneficiary is initially placed on board the ambulance','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '842','code_group' => 'value_codes','code' => 'A1','desc' => 'Deductible Payer A','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '843','code_group' => 'value_codes','code' => 'A2','desc' => 'Coinsurance Payer A','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '844','code_group' => 'value_codes','code' => 'A3','desc' => 'Estimated Responsibility Payer A','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '845','code_group' => 'value_codes','code' => 'A4','desc' => 'Covered Self-Administrable Drugs-Emergency - The amount included in covered charges for SAD administered to the patient in an emergency situation e.g. insulin for diabetic coma. Must be used with Rev Code 0637','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '846','code_group' => 'value_codes','code' => 'A5','desc' => 'Covered Self-Administrable Drugs-Not Self- Administrable in Form and Situation Furnished to Patient The amount included in covered charges for SAD administered to the patient because the drug wasn\'t self-administrable in the form and situation in which it was furnished to the patient. Must be used with Rev Code 0637','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '847','code_group' => 'value_codes','code' => 'A6','desc' => 'Covered-Self-Administrable Drugs-Diagnostic Study and Other The amount included in covered charges for SAD administered to the patient because the drug was necessary for diagnostic study or other reason. Must be used with Rev Code 0637','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '848','code_group' => 'value_codes','code' => 'A7','desc' => 'Co-payment Payer A','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '849','code_group' => 'value_codes','code' => 'A8','desc' => 'Patient Weight - Code indicates weight of patient in kilograms. The weight of the patient should be measured after dialysis during the last dialysis session of the month. For newborns, use value code 54.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '850','code_group' => 'value_codes','code' => 'A9','desc' => 'Patient Height - Code indicates the height of the patient in centimeters. The height should be measured during the last dialysis session of the month.','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '851','code_group' => 'value_codes','code' => 'AA','desc' => 'Regulatory Surcharges, Assessments, Allowances or Health Care Related Taxes Payer A','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '852','code_group' => 'value_codes','code' => 'AB','desc' => 'Other Assessments or Allowances (e.g., Medical Education) Payer A','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '853','code_group' => 'value_codes','code' => 'B1','desc' => 'Deductible Payer B','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '854','code_group' => 'value_codes','code' => 'B2','desc' => 'Coinsurance Payer B','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '855','code_group' => 'value_codes','code' => 'B3','desc' => 'Estimated Responsibility Payer B','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '856','code_group' => 'value_codes','code' => 'B7','desc' => 'Co-payment Payer B','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '857','code_group' => 'value_codes','code' => 'BA','desc' => 'Regulatory Surcharges, Assessments, Allowances or Health Care Related Taxes Payer B','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '858','code_group' => 'value_codes','code' => 'BB','desc' => 'Other Assessments or Allowances (e.g., Medical Education) Payer B','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '859','code_group' => 'value_codes','code' => 'C1','desc' => 'Deductible Payer C','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '860','code_group' => 'value_codes','code' => 'C2','desc' => 'Coinsurance Payer C','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '861','code_group' => 'value_codes','code' => 'C3','desc' => 'Estimated Responsibility Payer C','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '862','code_group' => 'value_codes','code' => 'C7','desc' => 'Co-payment Payer C','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '863','code_group' => 'value_codes','code' => 'CA','desc' => 'Regulatory Surcharges, Assessments, Allowances or Health Care Related Taxes Payer C','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '864','code_group' => 'value_codes','code' => 'CB','desc' => 'Other Assessments or Allowances (e.g., Medical Education Payer C','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '865','code_group' => 'value_codes','code' => 'D3','desc' => 'Estimated Responsibility Patient','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '866','code_group' => 'value_codes','code' => 'D4','desc' => 'Clinical Trial Number - 8-digit numeric','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '867','code_group' => 'value_codes','code' => 'D5','desc' => 'Result of last Kt/V In-center hemodialysis - last reading during billing period; peritoneal/home dialysis - within 4 months of claim date of service. IF not Kt/V test performed use value of 9.99 with D5','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '868','code_group' => 'value_codes','code' => 'DR','desc' => 'Reserved by Disaster Related code','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '869','code_group' => 'value_codes','code' => 'E0','desc' => 'Reserved for National Assignment','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '870','code_group' => 'value_codes','code' => 'E1','desc' => 'Deductible Payer D','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '871','code_group' => 'value_codes','code' => 'E2','desc' => 'Coinsurance Payer D','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '872','code_group' => 'value_codes','code' => 'E3','desc' => 'Estimated Responsibility Payer D','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '873','code_group' => 'value_codes','code' => 'E7','desc' => 'Co-payment Payer D','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '874','code_group' => 'value_codes','code' => 'EA','desc' => 'Regulatory Surcharges, Assessments, Allowances or HealthCare Related Taxes Payer D','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '875','code_group' => 'value_codes','code' => 'EB','desc' => 'Other Assessments or Allowances (e.g., Medical Education) Payer D','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '876','code_group' => 'value_codes','code' => 'F1','desc' => 'Deductible Payer E','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '877','code_group' => 'value_codes','code' => 'F2','desc' => 'Coinsurance Payer E','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '878','code_group' => 'value_codes','code' => 'F3','desc' => 'Estimated Responsibility Payer E','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '879','code_group' => 'value_codes','code' => 'F7','desc' => 'Co-payment Payer E','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '880','code_group' => 'value_codes','code' => 'FA','desc' => 'Regulatory Surcharges, Assessments, Allowances or HealthCare Related Taxes Payer E','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '881','code_group' => 'value_codes','code' => 'FB','desc' => 'Other Assessments or Allowances (e.g., Medical Education) Payer E','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '882','code_group' => 'value_codes','code' => 'FC','desc' => 'Patient Prior Payments','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '883','code_group' => 'value_codes','code' => 'G0','desc' => 'Reserved for National Assignment','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '884','code_group' => 'value_codes','code' => 'G1','desc' => 'Deductible Payer F','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '885','code_group' => 'value_codes','code' => 'G2','desc' => 'Coinsurance Payer F','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '886','code_group' => 'value_codes','code' => 'G3','desc' => 'Estimated Responsibility Payer F','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '887','code_group' => 'value_codes','code' => 'G4','desc' => ' G6 Reserved for National Assignment','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '888','code_group' => 'value_codes','code' => 'G7','desc' => 'Co-payment Payer F','desc1' => '','desc2' => '','desc3' => ''), |
|
array('id' => '889','code_group' => 'value_codes','code' => 'G8','desc' => 'Facility where inpatient hospice service is delivered','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '890','code_group' => 'value_codes','code' => 'G9','desc' => 'Reserved for National Assignment','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '891','code_group' => 'value_codes','code' => 'GA','desc' => 'Regulatory Surcharges, Assessments, Allowances or HealthCare Related Taxes Payer F','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '892','code_group' => 'value_codes','code' => 'GB','desc' => 'Other Assessments or Allowances (e.g., Medical Education) Payer F','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '893','code_group' => 'value_codes','code' => 'Y1','desc' => 'Part A Demonstration Payment - Part A payment under demonstration instead of DRG payment','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '894','code_group' => 'value_codes','code' => 'Y2','desc' => 'Part B Demonstration Payment - Part B payment under demonstration','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '895','code_group' => 'value_codes','code' => 'Y3','desc' => 'Part B Coinsurance (Demonstration Claims) - Part B coinsurance payment under demonstration','desc1' => '','desc2' => '','desc3' => ''), |
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array('id' => '896','code_group' => 'value_codes','code' => 'Y4','desc' => 'Conventional Provider Payment Amount for Non-Demonstration Claims - Amount Medicare would have reimbursed the provider if there had been no demonstration','desc1' => '','desc2' => '','desc3' => '') |
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);
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