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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

May 2018

Reminder: Report Condition and Value Codes on Institutional Claims


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)

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