Box 18-28 - Condition Codes

Box Definition 

Boxes 18-28 on the UB-04 contain patient condition codes. These codes report conditions or events related to the bill that may impact its processing. Condition codes should be entered in a two-character alphanumeric or numeric sequence and can appear no more than 11 times on a claim instance.

In Kipu RCM

Let's review how to update Box 18-28 in the RCM!

• Condition Codes can be added to a claim when a correction is processed. For more information on processing claims, click here.
• Claim Condition Codes can be added using a Service Grouping Rule. To learn more about this rule, click here. Additionally, a Claim Form Rule can be used to require or omit condition codes. However, new claims will require the Service Grouping Rule to be in place first so the system knows which code to include. For more information on this rule, click here.
• Claim Condition Codes can be added to a claim before submitting it using our Claim Edits feature. To learn more about this feature, click here.

EDI Loop and Segment

Loop 2300, Segment HI, Qualifier BG. For additional information on loops and segments, click here.