PPS Billing – Condition Code 47

As of July 1, 2010 you will no longer be able to use point of origin code (source of admission) B=”transfer from another home health agency”, or C=”readmission to same home health agency.”  Instead, CMS wants you to use condition code 47=”transfer from another home health agency.”  Code C will not be replaced.  Codes B & C have already been removed from the system.

Currently, the only way to enter a condition code for an patient is under patients, insurance, UB04 Info.  This would become awkward to use for PPS billing being that you may want condition code 47 for some OASIS assessments and not for others, for the same patient.

We added a new condition code field under PPS Billing / PPS Billing Information.  If a condition code is entered into this field it will be used only for billing for that OASIS assessment.  Other condition code can still be entered under the patient maintenance.

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