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Medicare Billing: 837I & Form CMS-1450

Loop 2300 HI/FLs 18-28

situationally required icon

You must use when a condition code is available to describe a situation on the claim.

Table 34: Loop 2300 HI/FLs 18-28 fields
Condition CodesSource
Condition codes identify conditions or events relating to this bill that may affect processing.NUBC

Enter the corresponding condition code to describe conditions or events that apply to the billing period. The codes help determine patient eligibility and benefits to administer primary or secondary insurance coverage.

  • 02 – Condition is employment related
  • 20 – Patient requested billing (demand bill)
  • 21 – Billing for denial notice
  • 41 – Partial hospitalization
  • 44 – Inpatient admission changed to outpatient
  • 67 – Patient elects not to use Lifetime Reserve (LTR) days
  • 77 – Provider accepts or is obligated/required, due to a contractual arrangement, by law to accept payment by a primary payer as payment in full
  • D0 – Changes to service dates
  • D1 – Changes to charges

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