Loop 2300 HI/FL 70 a-c | Medicare Billing: CMS-1450 & 837I

The NUBC Official Data Specifications Manual outlines under what circumstances the patient's reason for visit is required on an outpatient claim under the instructions for Form Locator 70 a-c.

Table 48: Loop 2300 HI/FL 70 a-c Fields
Patient Reason for Visit Code	Source
CMS restricts the requirement for reporting Patient’s Reason for Visit to the outpatient bill types below. Report this code on Medicare institutional claims processing on types of bill 013x and 085x when they meet the following criteria: You report codes 1, 2, or 5 in Form Locator 14 Priority (Type) of Admission or Visit You report revenue codes 045x, 0516, or 0762 Providers can report this code on types of bill 013X and 085x when information supports medical necessity even if services don't meet the above criteria.	ICD-10 diagnosis code