A3. Benefits Exhausted – last date benefits are available and no payment can be made by Payer A. A4. Split Bill Date (date patient became Medicaid eligible due to medically needy spend down)

What is a occurrence code on a claim?

Occurrence Codes identify a significant event relating to an institutional claim that may affect payer processing. These codes are claim-related occurrences that are related to a time period (span of dates).

What are condition codes?

Condition codes are extra bits kept by a processor that summarize the results of an operation and that affect the execution of later instructions. These bits are often collected together in a single condition or indicator register (CR/IR) or grouped with other status bits into a status register (PSW/PSR).