As a reminder, when submitting UB-04 and 837I institutional claims, please report any applicable condition codes (FL 12-28) and value codes and amounts (FL 39-41). The inclusion of condition codes and value codes is integral to the timely and accurate processing of institutional claims, because they provide vital information about particular services, conditions, and/or special circumstances related to the patient.
In addition, when reporting any of the condition codes indicated below on a claim, you must also report the value code FD and include the credit amount in the “Value Amount” field.
- 49 (Product replacement within product lifecycle)
- 50 (Product replacement for known recall)
- 53 (Initial placement of medical device provided as part of clinical trial or free sample)