Box 10d. - Claim Codes (Designated by NUCC)

The “Claim Codes” identify additional information about the patient’s condition or the claim.

Instructions: When applicable, use to report “Claim Codes.” Applicable Claim Codes are designated by the NUCC. Please refer to the most current instructions from the public or private payer regarding the need to report claim codes.

When required by payers to provide the sub-set of Condition Codes approved by the NUCC, enter the Condition Code in this field. The Condition Codes approved for use on the 1500 Claim Form are available at www.nucc.org under Code Sets.

For Workers Compensation Claims: Condition Codes are required when submitting a bill that is a duplicate or an appeal. (Original Reference Number must be entered in Box 22 for these conditions). Note: Do not use Condition Codes when submitting a revised or corrected bill.

This field allows for the entry of 19 characters.
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Note:Use this item exclusively for Medicaid (MCD) information. If the patient is entitled to Medicaid, enter the patient's Medicaid number preceded by MCD.

Note: In PrtCap only, Payer ID & Payer Sub populate this box to enter up to 17 char.
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Primary PAYOR... MUST BE set as Medicare or have Medicare in the name.

Go to secondary guarantor/open/policy and coverage/group plan #

In caps, enter MEDIGAP, MEDICAID.

Note - There must be a secondary guarantor selected on the condition screen for this to print

Note - When printing primary: MG prints for Medigap, MCD prints for Medicaid.

Note - NY WC (Must be 7/11/03 or newer)
1. Ensure patient is set up correctly for Worker's comp (Emp. related, accident = other).
2. Pri payer source of payment is WC (no sec payer or 10D will be blank [been this way since v8]).
2. Enter PI / WC / State then WC screen
3. Ensure that the Carrier Case # field is filled out, which is box 10d.

Note - v9; 8/12/04 or above. When Medicare is primary and a CMS 1500 is printed for the secondary, MSP is no longer printed in 10d.

Note - PrtCap: 10d may also be used to enter up to 17 char in the Payer ID + 17 char in the payer sub-ID. It does move 11d over. (If doesn't work, update to 4/18/07 or above).

Note - 4/22/07: OH Medicaid - changes for OH Medicaid box 10D. This data must be entered when you edit the bill by pressing the UB-04 / Medicaid button. The top box, as indicated, is used to enter your single digit code. Medicaid expects this information after you have billed all other sources of payment for this claim.

Note - In Va, When printing primary bill and if Medicare is secondary and has the word "Medicare" in the name then MSP prints in 10d.

Note - 2/2/12: CA Worker’s Comp requires additional information in fields 10D and 22 on the printed CMS 1500 form when re-submitting “duplicate” or “appeal” claims. You can now enter this information independently on each bill by editing the bill and pressing the UB-04 / CMS extras button. (Only on paper)