UB04/CMS1450 Condition Codes - Group 3
- 30 Non-research services provided to all patients, including managed care enrollees, enrolled in a Qualified Clinical Trial. UB04 Condition Code
- 31 Patient declares that they are enrolled as a full-time day student. UB04 Condition Code
- 32 Patient declares that they are enrolled in a cooperative/work study program. UB04 Condition Code
- 33 Patient declares that they are enrolled as a full-time night student. UB04 Condition Code
- 34 Patient declares that they are enrolled as a part-time student. UB04 Condition Code
- 35 Reserved for National Assignment UB04 Condition Code
- 36 (Not used by hospitals under PPS.) The hospital temporarily placed the patient in a special care unit because no general care beds were available.
- 37 (Not used by hospitals under PPS.) The patient was assigned to ward accommodations at their own request. UB04 Condition Code
- 38 (Not used by hospitals under PPS.) Either private or ward accommodations were assigned because semi-private accommodations were not available. UB04
- 39 (Not used by hospitals under PPS.) Either private or ward accommodations were assigned because semi-private accommodations were not available. UB04
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What are UB04 Condition Codes?
Form CMS-1450 (UB-04)This form, also known as the UB-04, is a uniform institutional provider bill suitable for use in billing multiple third party payers. Because it serves many payers, a particular payer may not need some data elements. The National Uniform Billing Committee (NUBC) maintains lists of approved coding for the form. All items on Form CMS-1450 are described. The FI must be able to capture all NUBC-approved input data described in section 75 (of the Medicare Claims Processing Manual Chapter 25) for audit trail purposes and be able to pass all data to other payers with whom it has a coordination of benefits agreement.
CMS1450/UB04 Fields: 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, and 28 are places for Condition Codes. The provider enters the corresponding code (in numerical order) to describe any conditions or events that apply to the billing period.
Source: Adapted from the Medicare Claims Processing Manual Chapter 25 - Completing and Processing the Form CMS-1450 Data Set
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