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. 


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:


EDI Loop

Loop 2300, Segment HI, Qualifier BE

Related Articles

Claim Rules

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