AHA Coding Clinic® for ICD-9 - 1999 Fourth Quarter
New Notes
Patient's Reason for Visit Effective for services furnished on or after April 1, 2000, Form Locator 76 on the UB-92 data set will have a dual use. Form Locator 76 (FL76) will be the "Admitting Diagnosis" for inpatient claims, and "Patient's Reason for Visit" on outpatient claims. The new definition reads: "The ICD-9-CM diagnosis code describing the patient's diagnosis or reason for visit at the time of admission or outpatient registration." The "Note" reference for FL76 has a section explaining that for outpatient claims, the ICD- 9-CM code describing the patient's stated reason for seeking care (or as...
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Article Overview
This article covers a UB-92 form update affecting Form Locator 76 and explains how outpatient claims should capture the patient’s stated reason for seeking care. It is aimed at billing and coding professionals who need to understand the scope of the change, the organizations involved, the effective date, and the general context for reporting outpatient versus inpatient information. The article also includes illustrative coding examples and a note about a diagnosis category update tied to the effective date.
Why This Topic Matters
The update affects how claims are prepared and why certain outpatient encounters may be described differently from the final diagnosis. Understanding the change helps billing and coding staff recognize when the form requires a reason-for-visit entry and how the guidance relates to claim processing.
Article Sections
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Patient's Reason for Visit
Explains the UB-92 change to Form Locator 76 and the general outpatient versus inpatient distinction for the reported information. It also describes the broader purpose of the update and references the organizations and effective date tied to the change.
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Coding examples follow:
Introduces example scenarios illustrating the type of outpatient and emergency visit situations addressed by the guidance. A note in this part of the article references a later code-set update related to the same timeframe.
What You Will Learn
- How Form Locator 76 changed for outpatient claims
- What broad type of information is intended for the outpatient reason-for-visit field
- Which general claim situations the update is meant to address
- How the article frames the relationship between visit reason and final diagnosis
- What kinds of examples accompany the guidance
Who Should Read This
- Medical coders
- Billing specialists
- Revenue cycle staff
- Hospital outpatient coding staff
Codes Discussed
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