List of Medicare Condition Codes – Medical Billing and Coding

Medicare Condition codes are used in medical billing to indicate specific conditions or circumstances related to a patient’s hospital stay. These codes help Medicare and other insurance companies to determine the appropriate payment for the services provided.

The Medicare Condition codes are a set of two-digit codes that can be added to a patient’s claim to provide additional information about their hospital stay. Some common Medicare Condition codes include:

• Code 21: Discharged/Transferred to Court/Law Enforcement
• Code 30: Still a Patient
• Code 70: Coronary Bypass
• Code 71: Heart Transplant
• Code 80: Discharged/Transferred to Hospice

These codes can affect the payment amount, coverage, and eligibility for certain services. Therefore, it is important for medical billing professionals to ensure that the correct Medicare Condition codes are included on the claim.

It is worth noting that Medicare Condition codes are specific to Medicare billing and may not be used by other insurance companies. Additionally, other insurance companies may have their own set of codes that serve a similar purpose.

Medicare Condition codes are used to identify specific conditions or circumstances related to a patient’s hospital stay. Here are some examples of Medicare Condition codes:

1. Code 21: “Discharged/Transferred to Court/Law Enforcement”
2. Code 30: “Still a Patient”
3. Code 70: “Coronary Bypass”
4. Code 71: “Heart Transplant”
5. Code 72: “Lung Transplant”
6. Code 74: “Bone Marrow Transplant”
7. Code 75: “Liver Transplant”
8. Code 76: “Kidney Transplant”
9. Code 80: “Discharged/Transferred to Hospice”
10. Code 81: “Discharged/Transferred to Inpatient Hospice Facility”
11. Code 82: “Discharged/Transferred to Hospice – Home”
12. Code 83: “Discharged/Transferred to Hospice – Medical Facility”
13. Code 84: “Discharged/Transferred to Hospice – Not Medical Facility”
14. Code 85: “Discharged/Transferred to Chronic Care Facility”
15. Code 86: “Discharged/Transferred to Federal Health Care Facility”
16. Code 87: “Discharged/Transferred to Home under Care of Organized Home Health Service Organization”
17. Code 88: “Discharged/Transferred to Home under Care of a Home Health Agency”
18. Code 89: “Discharged/Transferred within this Institution to Hospice”

Note that this list is not exhaustive and there may be additional codes depending on the specific situation or circumstance of the patient’s hospital stay.