Medicare Claims Processing Manual (Pub. 100-04), Ch. 4 § 40.1.1

Patient Status Code and Reason for Patient Visit for the

Last amended: 2004Year: 2004Length: 150 wordsOfficial source
40.1.1 - Patient Status Code and Reason for Patient Visit for the Hospital OPPS (Rev. 243, Issued 07-23-04, Effective: January 1, 2005/Implementation: January 3, 2005) In order to ensure that OPPS claims are being submitted and processed to payment in accordance with OPPS payment policy, CMS must be able to monitor information reported by hospitals on Form CMS-1450 in Form Locators (FLs) 22 (Patient Status) and 76 (Reason for Patient Visit). This instruction requires the Shared System Maintainer to make changes to ensure that the information in FLs 22 and 76, from claims submitted on bill type 13x, is passed to the OPPS Outpatient Code Editor (OCE) and to the Common Working File (CWF). This instruction also requires the Common Working File Maintainer to make changes to ensure that the information in FL 76, from claims submitted on bill type 13x, is passed to the National Claims History (NCH) files.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 4 § 40.1.1: Patient Status Code and Reason for Patient Visit for the | Justis AI