13/16 Point of Origin Admission/Visit - FL 15 Patient Discharge Status - FL 17 Condition Codes - FLs 18-28 Occurrence Codes - FLs 31-34 Occurrence Span Codes - FLs 35-36 Value Codes and Amounts - FLs 39-41 Revenue Codes - FL 42 Code Codes - FL 81 Other UB04 Claim Form Codes ...
18 through 28 – Condition Codes: These fields are where you enter codes for conditions that may affect bill processing. 39 through 41 – Value Codes and Amounts: Here you enter codes and corresponding dollar amounts so insurance providers understand the costs of the claims. 42 – Revenue Cod...