June 14, 2013
Beginning 8/18/2013, a new edit enforcing NUBC billing guidelines will be implemented for the following payers:
Purpose: If an institutional claim indicates a patient discharge status of 20, 40, 41 or 42 (patient expired), then Occurrence Code 55 (date of death) must be reported.
Edit Logic: Occurrence Code 55 (date of death) (2300 HI01-1 through HI12-2 when HI01-1=BH) is required when the patient discharge status (2300 CL103) = 20, 40, 41 or 42, else reject
Edit Code: A8:234 / A8:719