Claim Form Rule - Add or Remove Condition Codes

  • Updated

What claim change is needed?

Adding or removing claim condition codes on the UB-04 and CMS-1500 claim forms.

Claim resubmission condition codes are added during claim correction in the Resolve > Select Correction Action dialog but aren't added to the claim form by default. A claim form rule is needed.


Box Number

UB-04: Box 18-28 - Condition Codes

CMS-1500: N/A


  1. Navigate to Management Center > Claim Rules
  2. Click "Create Claim Form Rule".
  3. Select the practice.
  4. Name the claim rule.mceclip0.png
  5. Set the claim type to Institutional
  6. Set conditions for the claim rule to meet.
  7. Under available behaviors, select Claim Condition Codesmceclip2.png
  8. Select Add
  9. Enter Claim Condition Codes.

    Note: Claim condition codes for the Claim Form Rule are added during the correction workflow. For this claim rule, the user is limited to either Omit, Require and Write to Claim, or Write to Claim if Present:
  10. Save

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