Patient reason for visit codes is required on institutional claims when the Type of Bill is 013X (hospital outpatient) and 085X (Critical Access Hospital) when the type of visit codes are 1, 2, or 5 and revenue codes 045X, 0516, or 0762 are billed. Additional information regarding the patient's reason for visit code can be found in the Medicare Claims Processing Manual on the CMS website.
If you need to include this information on your claim, you can enter it easily on the patient's appointment.
- Navigate to Billing > Live Claims Feed > inside the patient's appointment, right side of the screen > Info tab
