September 27, 2013

HHA-13-15
DC-13-15
ASC-13-16
MS-13-18

BC-13-18
SA-13-15
HP-13-15

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:

Point of Origin for Admission or Visit (Field Locator 15) code required effective October 1, 2013

The Point of Origin for Admission or Visit (UB04 Claim Form Field Locator 15) uses a code that indicates the patient's point of origin for the current admission or visit. The code is designed to focus on patient's point of admission rather than the source of a physician order or referral. The point of origin (PoO) is defined as where the patient came from before presenting to the health care facility. The electronic equivalent to FL 15 is 2300 CL102.

Effective October 1, 2013 the Point of Origin for Admission or Visit Code will be required on all claims submitted on a UB04 claim form, except when the type bill is 14X. On that date, when the PoO (FL 15) field is blank and the type bill is not 14X, the claim will be denied.

Below is the list of codes that are accepted for the Point of Origin for Admission or Visit in FL 15 on the UB-04 claim form.

Code Point of Origin Definition
1 Non-Health Care Facility Inpatient:  The patient was admitted to this facility.
Outpatient: The patient presented for outpatient services.
2 Clinic or Physician's Office Inpatient:  The patient is admitted to this facility.
Outpatient:  The patient presented to this facility for outpatient services.
4 Transfer from a Hospital (Different Facility) Inpatient:  The patient was admitted to this facility as a hospital transfer from an acute care facility where he/she was an inpatient or outpatient.
Outpatient: The patient was transferred to this facility as an outpatient t form an acute care facility.
5 Transfer from a Skilled Nursing Facility (SNF), Intermediate Care Facility (ICF) or Assisted Living Facility (ALF) Inpatient:  The patient was admitted to this facility as a transfer from a SNF, ICF or ALF where he/she was a resident.
Outpatient:  The patient presented to this facility for outpatient or referenced diagnostic services from a SNF, ICF or ALF where he or she was a resident.
6 Transfer from another Health Care Facility Inpatient: The patient was admitted to this facility as a transfer from another type of health care facility not defined elsewhere in this code list.
Outpatient:  The patient presented to this facility for services from another health care facility not defined elsewhere in this code set.
8 Court/Law Enforcement Inpatient:  The patient was admitted to this facility upon the direction of a court of law, or upon the request of a law enforcement agency representative.
Outpatient:  The patient presented to this facility upon the direction of a court of laws, or upon the request of a law enforcement agency representative for outpatient or referenced diagnostic services.
9 Information not Available Inpatient:  The Patient's PoO is not known.
Outpatient:  The patient's PoO is not known.
D Transfer from one distinct unit of the hospital to another distinct unit of the same hospital resulting in a separate claim to the Payer Inpatient:  The patient was admitted to this facility as a transfer from hospital inpatient within this hospital resulting in a separate claim to the payer.
Outpatient:  The patient received outpatient services in this facility as a transfer from within this hospital resulting in a separate claim to the payer.
E Transfer from Ambulatory Surgery Center Inpatient:  The patient was admitted to this facility as a transfer from an ambulatory surgery center.
Outpatient:   The patient presented to this facility for outpatient or referenced diagnostic services from an ambulatory surgery center.
F Transfer from a Hospice Facility Inpatient: The Patient was admitted to this facility as a transfer from a hospice facility.
Outpatient:  The patient presented to this facility for outpatient or referenced diagnostic services form a hospice facility.

If you have questions regarding this newsletter, please contact your Institutional Provider Representative.  Denny Hartman can be reached at 1-316-269-1602, Cindy Garrison at 1-785-291-8862 and Janne Adams-Denton at 1-785-291-8813.

 

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