June 20, 2013

HHA-13-4
DC-13-4
ASC-13-5
MS-13-6

BC-13-6
SA-13-4
HP-13-4

To:

All Blue Cross and Blue Shield of Kansas Contracting Providers

From:

Connie Winkley – Education/Communication Coordinator
Institutional Provider Relations
Blue Cross and Blue Shield of Kansas, Inc.
An Independent Licensee of the Blue Cross and Blue Shield Association

Subject:

NUBC enforcement of Occurrence Code 55 on the UB-04 claim form

The Official UB-04 Data Specifications Manual is the official source of UB-04 billing information adopted by the National Uniform Billing Committee (NUBC).  The NUBC has implemented a requirement regarding Occurrence Code 55 on the UB-04 claim form.

If the claim indicates a patient discharge status of 20, 40, 41 or 42 (patient expired), then Occurrence Code 55 (date of death) must be reported.  The Occurrence Code 55 requirement applies to both electronic and paper claims.  Effective August 18, 2013 Blue Cross and Blue Shield of Kansas (BCBSKS) will enforce this requirement for providers submitting claims for BCBSKS members.  If a claim is submitted with one of the above discharge status codes, but without the Occurrence Code 55, the claim will be rejected.

Providers can find additional information on the Editing for Occurrence Code 55 under the News Section of the ASK EDI website

If you have questions regarding this newsletter, please contact your Institutional Provider Representative.  Denny Hartman can be reached at 1-316-269-1602 and Cindy Garrison can be reached at 1-785-291-8862.

 

cw