June 23, 2010

BC-10-06
HP-10-05
SA-10-05
MS-10-05

HHA-10-05
DC-10-04
ASC-10-04

Cindy Garrison, CPC – Education/Communication Coordinator
Institutional Relations
Blue Cross and Blue Shield of Kansas, Inc.
An Independent Licensee of the Blue Cross and Blue Shield Association

UB04 Changes:  Point of Origin Deletions and New Condition Code

The National Uniform Billing Committee (NUBC) has initiated changes to the Point of Origin (PoO) Codes effective July 1, 2010. 

With NUBC wanting to place the emphasis on where the patient came from before presenting to the health care facility, the following changes are effective with date of service July 1, 2010:

• Discontinued
• '7' – Emergency Room
• 'B' – Transfer From Another Home Health Agency
• 'C' – Readmission to Same Home Health Agency
• Definition change
• '1' – Non-Heath care Facility Point of Origin
• Inpatient: The patient was admitted to this facility.
• Outpatient: The patient presented to this facility for outpatient services.
• '2' – Clinic or Physician's Office
• Inpatient: The patient was admitted to this facility.
• Outpatient: The patient presented to this facility for outpatient services.

Because of the approved changes to the above PoO Codes, changes to the Condition Codes were also needed.  Effective July 1, 2010 the following Condition Code was added:

• 'P7' – Direct Inpatient Admission from Emergency Room.
  • Code indicates that the patient was admitted directly from this facility's emergency room/department.

Claims with a service begin date prior to July 1, 2010, should continue to use PoO Code 7 for an admission to an inpatient facility when a patient is admitted through the emergency room/department.  Claims with a begin date on and after July 1, 2010, should use the new Condition Code P7 to indicate a patient was admitted to the facility through the emergency room/department.

 REFERENCES:
www.cms-hhs.org  

cg