Box 39, 40, 41 - Value Code/Amount

Box Description

Boxes 39, 40, and 41 contain the codes and related dollar amounts to identify the monetary data for processing claims. 

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In AveaOffice

There are four value codes that AveaOffice supports:

  • Value Code 01 - Most Common Semi-Private Rate
  • Value Code 80 - Covered Units
  • Value Code 81 - Non-covered Units
  • Value Code A3 - Estimated Responsibility - Payer A

To include a Value Code, use a Claim Form Rule 'Behavior' based upon the conditions where a Value Code is required:

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EDI Loop

Loop 2300, Segment HI, Qualifier BE

Related Articles

Claim Rules

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