Box 70a-c - Patient Reason DX

Box Description

A Patient Reason For Visit Code is an ICD-10 code that codes the patient's stated reason for seeking outpatient care and may differ from the principal or admitting diagnosis code. Up to 3 codes can be submitted on an outpatient claim.



In AveaOffice

The Patient Reason for Visit Code will print to the claim form as the first diagnosis code from Intake >  Standalone Service Diagnoses. In order to include the Patient Reason for Visit Code, a claim form rule will be required.  Perform the following steps to create this rule:

  1. From the Main Menu, navigate to Management Center > Claim Rules and select Create Claim Form Rule.Screen_Shot_2021-05-12_at_8.51.53_PM.png
  2. Select the practice that requires the claim rule.Screen_Shot_2021-05-12_at_8.49.09_PM.png
  3. Select the conditions that will require the patient reason for visit code.  Generally, we will see the Current Sequence Behavioral Payer should be set to a specific payer and the Bill Type Prefix is set to 13, 78, or 85.
  4. Select the Behavior to "Diagnosis - Patient Reason for Visit Code".  
  5. When creating new claims, confirm the claim rule is working by clicking the View link next to the claim.  Users should see Box 70a for Patient Reason for Visit 1 and the code.Screen_Shot_2021-05-12_at_9.01.48_PM.png
  6. Users can also look at the PDF by clicking the Preview link next to the claim to see Box 70 include in the Patient Reason DX.Screen_Shot_2021-05-12_at_9.03.55_PM.png

EDI Loop

Loop 2300, Segment HI


Related Articles

Claim Rule: UHC Rejection - Patient Reason For Visit Codes

Was this article helpful?

0 out of 0 found this helpful



Please sign in to leave a comment.