Crystal's MCW Coder Hub🏷️ Condition Code Reference
🎯 Purpose
Quick reference for common condition codes used on UB‑04 claims.
🧩 Common Condition Codes
| Code | Meaning |
|---|---|
| 01 | Military service related |
| 04 | HMO enrollment |
| 20 | Beneficiary requested billing |
| 21 | Billing for denial |
| 44 | Change from inpatient to outpatient |
| 78 | SNF prior stay |
| 79 | No SNF prior stay |
🧠 Notes
- Condition codes affect billing logic, not diagnosis
- Code 44 requires physician concurrence
- Use with Type of Bill for correct claim routing