Occurrence Codes
These slides cover how to complete the occurrence code portion of the CMS-1450 and 837I forms.
Loop 2300 HI/FLs 31-34
| Occurrence Code and Date | Source |
|---|---|
| Enter a code and associated dates defining specific events relating to the billing period. | NUBC |
Use these codes to decide payment liability, coordinate benefits, and administer subrogation.
- 02 –No-fault insurance involved – including auto accident/other
- 11 –Onset of symptoms – illness
- 16 –Date of last therapy
- 17 –Date outpatient occupational therapy plan established or last reviewed
- 23 –Date of cancellation of hospice election period
- 29 –Date outpatient physical therapy plan established or last reviewed
- 30 –Date outpatient speech pathology plan established or last reviewed
- 41 –Date of first test for preadmission testing
- 47 –Date cost outlier status begins
- A3 –Benefits exhausted
Copyright © 2025, the American Hospital Association, Chicago, Illinois. Reproduced with permission. No portion of the AHA copyrighted materials contained within this publication may be copied without the express written consent of the AHA. AHA copyrighted materials including the UB-04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution, or derivative work without the written consent of the AHA.
Loop 2300 HI/FLs 35-36
| Occurrence Span Code/From/Through | Source |
|---|---|
| Enter codes and dates that identify an event that spans a period of time related to the claim. | NUBC |
Occurrence span codes are 2 alpha-numeric digits, and dates show numerically as MMDDYY.
Examples of commonly used occurrence span codes include:
- 70 – Qualifying stay dates for SNF use only
- 72 – First/last visit
- 74 – Non-covered level of care dates/leave of absence dates
- 75 – SNF level of care
- 76 – Patient liability
- 78 – SNF prior stay dates
- M2 – Inpatient respite dates
Copyright © 2025, the American Hospital Association, Chicago, Illinois. Reproduced with permission. No portion of the AHA copyrighted materials contained within this publication may be copied without the express written consent of the AHA. AHA copyrighted materials including the UB-04 codes and desciptions may not be removed, copied, or utilized within any software, product, service, solution, or derivative work without the written consent of the AHA.