candidhealth 1.11.0 → 1.13.0

package/dist/api/resources/healthCareCodeInformation/resources/v1/types/ConditionCode.d.ts

@@ -1,635 +1,478 @@
 /**
- * This file was auto-generated by Fern from our API Definition.
- */
-/**
- *
  *     FL 18-28 - Condition Codes
  *     Source: UB-04 Manual 2025, Pages 64-81 (FL18-28, Pages 1-18)
  *     Excludes codes designated as "Payer Codes" or "FOR PUBLIC HEALTH DATA REPORTING ONLY"
  *     unless usage on claims is indicated.
  *
  */
-export type ConditionCode = 
-/**
- * MILITARY SERVICE RELATED - Medical condition incurred during military service. */
-"01"
-/**
- * CONDITION IS EMPLOYMENT RELATED - Patient alleges that medical condition is due to environment/events resulting from employment. */
- | "02"
-/**
- * PATIENT COVERED BY INSURANCE NOT REFLECTED HERE - Indicates that patient/patient representative has stated that coverage may exist beyond that reflected on this bill. */
- | "03"
-/**
- * INFORMATION ONLY BILL - Indicates submission of bill is for informational purposes only. Examples would include a bill submitted as a utilization report, or a bill for a beneficiary who enrolled in a risk-based managed care plan and the hospital expects to receive payment from the plan. */
- | "04"
-/**
- * LIEN HAS BEEN FILED - Provider has filed legal claim for recovery of funds potentially due a patient resulting from legal action initiated by or on behalf of the patient. */
- | "05"
-/**
- * ESRD PATIENT IN FIRST 30 MONTHS OF ENTITLEMENT COVERED BY EMPLOYER GROUP HEALTH INSURANCE - Code indicates Medicare as the secondary insurer because the patient also is covered through an employer group health insurance during his first 30 months of End Stage Renal Disease (ESRD) entitlement. */
- | "06"
-/**
- * TREATMENT OF NON-TERMINAL CONDITION FOR HOSPICE PATIENT - Code indicates the patient is a hospice enrollee, but the provider is not treating his terminal condition and is therefore, requesting regular Medicare reimbursement. */
- | "07"
-/**
- * BENEFICIARY WOULD NOT PROVIDE INFORMATION CONCERNING OTHER INSURANCE COVERAGE - Enter this code if the beneficiary would not provide information concerning other insurance coverage. */
- | "08"
-/**
- * NEITHER PATIENT NOR SPOUSE IS EMPLOYED - Indicates that in response to development questions, the patient and spouse (if the patient is married) have denied any employment. */
- | "09"
-/**
- * PATIENT AND/OR SPOUSE IS EMPLOYED BUT NO EGHP EXISTS - Code indicates that in response to development questions, the patient and/or spouse have indicated that one is or both are employed but have no group health insurance from an EGHP or other employer sponsored or provided health insurance that covers the patient. */
- | "10"
-/**
- * DISABLED BENEFICIARY BUT NO LGHP - Code indicates that in response to development questions, the disabled beneficiary and/or family members have indicated that one is or more are employed but have no group health insurance from an LGHP or other employer sponsored or provided health insurance that covers the patient. */
- | "11"
-/**
- * PATIENT IS HOMELESS - The patient is homeless. */
- | "17"
-/**
- * MAIDEN NAME RETAINED - A dependent spouse entitled to benefits who does not use her husband's last name. */
- | "18"
-/**
- * CHILD RETAINS MOTHER'S NAME - A patient who is a dependent child entitled to benefits and does not have its father's last name. */
- | "19"
-/**
- * BENEFICIARY REQUESTED BILLING - Provider realizes services are non-covered level of care or excluded, but beneficiary requests determination by payer. (Currently limited to home health and inpatient SNF claims.) */
- | "20"
-/**
- * BILLING FOR DENIAL NOTICE - Provider realizes services are non-covered level of care or excluded, but requests notice from Medicare or other payer. */
- | "21"
-/**
- * PATIENT ON MULTIPLE DRUG REGIMEN - A patient who is receiving multiple intravenous drugs while on home IV therapy. */
- | "22"
-/**
- * HOME CARE GIVER AVAILABLE - The patient has a caregiver available to assist him or her during self-administration of an intravenous drug. */
- | "23"
-/**
- * HOME IV PATIENT ALSO RECEIVING HHA SERVICES - The patient is under the care of Home Health Agency while receiving home IV drug therapy services. */
- | "24"
-/**
- * PATIENT IS NON-U.S. RESIDENT - The patient is not a resident of the United States. */
- | "25"
-/**
- * VA ELIGIBLE PATIENT CHOOSES TO RECEIVE SERVICES IN A MEDICARE CERTIFIED FACILITY - Indicates that the patient is a VA eligible patient and chooses to receive services in a Medicare certified provider instead of a VA facility. */
- | "26"
-/**
- * PATIENT REFERRED TO A SOLE COMMUNITY HOSPITAL FOR A DIAGNOSTIC LABORATORY TEST - To be reported by Sole Community hospitals only. Report this code to indicate the patient was referred for a diagnostic laboratory test. Do not report this code when a specimen only is referred. */
- | "27"
-/**
- * PATIENT AND/OR SPOUSE’S EGHP IS SECONDARY TO MEDICARE - Code indicates that in response to development questions, the patient and/or spouse have indicated that one is or both are employed and that there is group health insurance from an EGHP or other employer sponsored or provided health insurance that covers the patient but that either: (1) the EGHP is a single employer plan and the employer has fewer than 20 full and part-time employees; or, (2) the EGHP is a multi or multiple employer plan that elects to pay secondary to Medicare for employees and spouses aged 65 and older for those participating employers who have fewer than 20 employees. */
- | "28"
-/**
- * DISABLED BENEFICIARY AND/OR FAMILY MEMBER’S LGHP IS SECONDARY TO MEDICARE - Code indicates that in response to development questions, the patient and/or family member(s) have indicated that one is or more are employed. There also is group health insurance coverage from a LGHP or other employer sponsored or provided health insurance that covers the patient. Generally, (1) the LGHP is a single employer plan and that the employer has fewer than 100 full and part-time employees; or, (2), the LGHP is a multiple employer plan and that all employers participating in the plan have fewer than 100 full and part-time employees. */
- | "29"
-/**
- * QUALIFYING CLINICAL TRIALS - Non-research services provided to patients enrolled in a Qualified Clinical Trial. */
- | "30"
-/**
- * PATIENT IS STUDENT (FULL TIME - DAY) - Patient declares that he or she is enrolled as a full time day student. */
- | "31"
-/**
- * PATIENT IS STUDENT (COOPERATIVE/ WORK STUDY PROGRAM) - Self-explanatory. */
- | "32"
-/**
- * PATIENT IS STUDENT (FULL TIME - NIGHT) - Patient declares that he or she is enrolled as a full time night student. */
- | "33"
-/**
- * PATIENT IS STUDENT (PART TIME) - Patient declares that he or she is enrolled as a part time student. */
- | "34"
-/**
- * PACE ELIGIBLE PATIENT DISENROLLS DURING AN INPATIENT ADMISSION - Indicates that the patient is a PACE eligible patient that has disenrolled from PACE during an inpatient admission. */
- | "35"
-/**
- * GENERAL CARE PATIENT IN A SPECIAL UNIT - Patient temporarily placed in special care unit bed because no general care beds available. */
- | "36"
-/**
- * WARD ACCOMMODATION AT PATIENT REQUEST - Patient assigned to ward accommodations at patient’s request. */
- | "37"
-/**
- * SEMI-PRIVATE ROOM NOT AVAILABLE - Indicates that either private or ward accommodations were assigned because semi- private accommodations were not available. */
- | "38"
-/**
- * PRIVATE ROOM MEDICALLY NECESSARY - Patient needs a private room for medical requirements. */
- | "39"
-/**
- * SAME DAY TRANSFER - Patient transferred to another facility before midnight on the day of admission. */
- | "40"
-/**
- * PARTIAL HOSPITALIZATION - Indicates claim is for partial hospitalization services. */
- | "41"
-/**
- * CONTINUING CARE NOT RELATED TO INPATIENT HOSPITALIZATION - Continuing care not related to the condition or diagnosis for which the individual received inpatient hospital services. */
- | "42"
-/**
- * CONTINUING CARE NOT PROVIDED WITHIN PRESCRIBED POST-DISCHARGE WINDOW - Continuing care related to the inpatient admission but the prescribed care was not provided within the post-discharge window. */
- | "43"
-/**
- * INPATIENT ADMISSION CHANGED TO OUTPATIENT - For use on outpatient claims only, when the physician ordered inpatient services, but upon internal utilization review performed before the claim was originally submitted, the hospital determined that the services did not meet its inpatient criteria. (Note: For Medicare, the change in patient status from inpatient to outpatient is made prior to discharge or release, while the beneficiary is still a patient of the hospital.) */
- | "44"
-/**
- * GENDER INCONGRUENCE - Characterized by a marked and persistent incongruence between an individual's experienced gender and the sex at birth. */
- | "45"
-/**
- * NON-AVAILABILITY STATEMENT ON FILE - A non-availability statement must be issued for each TRICARE claim for non-emergency inpatient care when the TRICARE beneficiary resides within the catchment’s area (usually a 40-mile radius) of a Uniformed Services Hospital. */
- | "46"
-/**
- * TRANSFER FROM ANOTHER HOME HEALTH AGENCY (EFFECTIVE 7/1/10) - The patient was admitted to this home health agency as a transfer from another home health agency. */
- | "47"
-/**
- * PSYCHIATRIC RESIDENTIAL TREATMENT CENTERS FOR CHILDREN AND ADOLESCENTS (RTCS) - Code to identify claims submitted by a “TRICARE - authorized” psychiatric Residential Treatment Center (RTC) for Children and Adolescents. */
- | "48"
-/**
- * PRODUCT REPLACEMENT WITHIN PRODUCT LIFECYCLE (EFFECTIVE 1/1/15) - Replacement of a product earlier than the anticipated lifecycle. */
- | "49"
-/**
- * PRODUCT REPLACEMENT FOR KNOWN RECALL OF A PRODUCT - Manufacturer or FDA has identified the product for recall and therefore replacement. */
- | "50"
-/**
- * ATTESTATION OF UNRELATED OUTPATIENT NONDIAGNOSTIC SERVICES (EFFECTIVE 4/1/11) - The hospital attests that the outpatient nondiagnostic service provided within 3 calendars days (1 calendar day for non-subsection (d) hospitals) prior to the admission is not related to the admission to the inpatient stay. For use on outpatient claims only. */
- | "51"
-/**
- * OUT OF HOSPICE SERVICE AREA (EFFECTIVE 7/1/12) - Code used when the patient is discharged for moving out of the hospice service area, including patients admitted to a hospital without contractual arrangements with the hospice. */
- | "52"
-/**
- * INITIAL PLACEMENT OF A MEDICAL DEVICE PROVIDED AS PART OF A CLINICAL TRIAL OR A FREE SAMPLE. (EFFECTIVE 7/1/15) - Code is for outpatient claims that have received a device credit upon initial medical device placement in a clinical trial or a free sample. */
- | "53"
-/**
- * NO SKILLED HOME HEALTH VISITS IN BILLING PERIOD. POLICY EXCEPTION DOCUMENTED AT THE HOME HEALTH AGENCY (EFFECTIVE 7/1/16) - Report when the Home Health claim is submitted without any skilled visits due to a circumstance that is allowed by the payer and indicate that the policy exception is documented at the Home Health Agency. */
- | "54"
-/**
- * SNF BED NOT AVAILABLE - Code indicates the patient’s SNF admission was delayed more than 30 days after hospital discharge because a SNF bed was not available. */
- | "55"
-/**
- * MEDICAL APPROPRIATENESS - Code indicates the patient’s SNF admission was delayed more than 30 days after hospital discharge because his condition made it inappropriate to begin active care within that period. */
- | "56"
-/**
- * SNF READMISSION - Code indicates the patient was previously receiving Medicare covered SNF care within 30 days of this readmission. */
- | "57"
-/**
- * TERMINATED MEDICARE ADVANTAGE ENROLLEE - Code indicates that patient is a terminated enrollee in a Medicare Advantage plan whose three-day inpatient hospital stay was waived. */
- | "58"
-/**
- * NON-PRIMARY ESRD FACILITY - Code indicates that ESRD beneficiary received non- scheduled or emergency dialysis services at a facility other than his/her primary ESRD dialysis facility. */
- | "59"
-/**
- * DAY OUTLIER - A hospital being paid under a prospective payment system is reporting this stay as a day outlier. */
- | "60"
-/**
- * COST OUTLIER - A hospital being paid under a prospective payment system is requesting additional payment for this stay as a cost outlier. */
- | "61"
-/**
- * PROVIDER DOES NOT WISH COST OUTLIER PAYMENT - A hospital paid under a prospective payment system is NOT requesting additional payment for this stay as a cost outlier. */
- | "66"
-/**
- * BENEFICIARY ELECTS NOT TO USE LIFE TIME RESERVE (LTR) DAYS - Indicates beneficiary elects not to use LTR days. */
- | "67"
-/**
- * BENEFICIARY ELECTS TO USE LIFE TIME RESERVE (LTR) DAYS - Indicates beneficiary has elected to use LTR days when charges are less than LTR co-insurance amounts. */
- | "68"
-/**
- * IME/DGME/N&AH PAYMENT ONLY - Code indicates a request for a supplemental payment for IME/DGME/N&AH (Indirect Medical Education/Graduate Medical Education/ Nursing and Allied Health). */
- | "69"
-/**
- * SELF-ADMINISTERED ANEMIA MANAGEMENT DRUG - Code indicates the billing is for a home dialysis patient who self administers an anemia management drug, such as erythropoietin alpha (EPO) or darbepoetin alpha. */
- | "70"
-/**
- * FULL CARE IN UNIT - Code indicates the billing is for a patient who received staff-assisted dialysis services in a hospital or renal dialysis facility. */
- | "71"
-/**
- * SELF CARE IN UNIT - Code indicates the billing is for a patient who managed his own dialysis services without staff assistance in a hospital or renal dialysis facility. */
- | "72"
-/**
- * ESRD SELF CARE TRAINING - Code indicates the billing is for special dialysis services training when a patient or caregiver is learning to perform dialysis. */
- | "73"
-/**
- * HOME - Code indicates the billing is for a patient who received dialysis services at home, but where code 75 below does not apply. */
- | "74"
-/**
- * HOME - 100 PERCENT REIMBURSEMENT - Code indicates the billing is for a patient who received dialysis services at home, using a dialysis machine that was purchased by Medicare under the 100 percent program. */
- | "75"
-/**
- * BACK-UP IN FACILITY DIALYSIS - Code indicates the billing is for a home dialysis patient who received back-up dialysis in a facility. */
- | "76"
-/**
- * PROVIDER ACCEPTS OR IS OBLIGATED/REQUIRED DUE TO A CONTRACTUAL ARRANGEMENT OR LAW TO ACCEPT PAYMENT BY A PRIMARY PAYER AS PAYMENT IN FULL. - Code indicates you have accepted or are
- * obligated/required due to a contractual
- * arrangement or law to accept payment as
- * payment in full. Therefore, no payment is due. */
- | "77"
-/**
- * NEW COVERAGE NOT IMPLEMENTED BY MANAGED CARE PLAN - Billing is for a newly covered service for which
- * the managed care plan/HMO does not pay. (Note:
- * For outpatient bills Condition Code 04 should be
- * omitted). */
- | "78"
-/**
- * CORF SERVICES PROVIDED OFFSITE - Enter this code to indicate that physical therapy,
- * occupational therapy, or speech pathology ser-
- * vices were provided offsite. */
- | "79"
-/**
- * HOME DIALYSIS - NURSING FACILITY - Home dialysis furnished in a SNF or nursing facility. */
- | "80"
-/**
- * C-SECTIONS/INDUCTIONS < 39 WEEKS - MEDICAL NECESSITY - C-sections or inductions performed at less than 39 weeks gestation for medical necessity. */
- | "81"
-/**
- * C-SECTIONS/INDUCTIONS < 39 WEEKS - ELECTIVE - C-sections or inductions performed at less than 39 weeks gestation electively. */
- | "82"
-/**
- * C-SECTIONS/INDUCTIONS 39 WEEKS OR GREATER - C-sections or inductions performed at 39 weeks gestation or greater. */
- | "83"
-/**
- * DIALYSIS FOR ACUTE KIDNEY INJURY (AKI) (EFFECTIVE 1/1/17) - Dialysis facilities (Type of Bill 072x) enter this code to indicate that the billing is for a patient with AKI. (Not to be used for patients with End Stage Renal Disease) */
- | "84"
-/**
- * DELAYED RECERTIFICATION OF HOSPICE TERMINAL ILLNESS (EFFECTIVE 1/1/17) - Used when hospice recertification is untimely. */
- | "85"
-/**
- * ADDITIONAL HEMODIALYSIS TREATMENTS WITH MEDICAL JUSTIFICATION (ORIGINAL EFFECTIVE DATE DELAYED. NEW EFFECTIVE DATE TBD*) - Enter this code to indicate that the billing is for a patient receiving hemodialysis who exhibits a medical condition that necessitates hemodialysis at a frequency greater than the patient’s plan of care and all treatments on the claim are reasonable and necessary. */
- | "86"
-/**
- * ESRD SELF CARE RETRAINING (EFFECTIVE 7/1/17) - Code indicates the billing is for special dialysis services retraining where the patient or caregiver has previously completed dialysis training. */
- | "87"
-/**
- * ALLOGENEIC STEM CELL TRANSPLANT RELATED DONOR CHARGES (EFFECTIVE 7/1/20) - Claim submitted is solely for separately billed charges for evaluating related stem cell transplant donor candidates prior to the actual transplant claim. */
- | "88"
-/**
- * OPIOID TREATMENT PROGRAM (EFFECTIVE 1/1/21) - Indicates claim is for opioid treatment program services. */
- | "89"
-/**
- * EXPANDED ACCESS APPROVAL (EFFECTIVE 2/1/21) - Service provided as part of an Expanded Access approval. */
- | "90"
-/**
- * EMERGENCY USE AUTHORIZATION (EFFECTIVE 2/1/21) - Service provided as part of an Emergency Use Authorization. */
- | "91"
-/**
- * INTENSIVE OUTPATIENT PROGRAM (IOP) (EFFECTIVE FOR SERVICES FURNISHED ON OR AFTER 1/1/2024) - Code indicates claim is for Intensive Outpatient Services */
- | "92"
-/**
- * TRICARE EXTERNAL PARTNERSHIP PROGRAM - This code identifies TRICARE claims submitted under the External Partnership Program. */
- | "A0"
-/**
- * BIRTH DATE - INSURED A - The birth date of the individual in whose name the insurance is carried. */
- | "A1"
-/**
- * PHYSICALLY HANDICAPPED CHILDREN’S PROGRAM - Services provided under this program receive special funding through Title VII of the Social Security Act or the TRICARE program for the Handicapped. */
- | "A2"
-/**
- * SPECIAL FEDERAL FUNDING - This code has been designed for uniform use as defined by state law. */
- | "A3"
-/**
- * FAMILY PLANNING - This code has been designed for uniform use as defined by state law. */
- | "A4"
-/**
- * DISABILITY - This code has been designed for uniform use as defined by state law. */
- | "A5"
-/**
- * VACCINES/MEDICARE 100% PAYMENT - This code identifies that pneumococcal pneumonia and influenza vaccine services are reimbursed under special Medicare program provisions and Medicare deductible and coinsurance requirements do not apply. */
- | "A6"
-/**
- * HOSPITAL SERVICES PROVIDED IN A MOBILE FACILITY OR WITH PORTABLE UNITS (EFFECTIVE 4/1/20). - Code indicates that hospital services were provided in a mobile facility or with portable units. */
- | "A7"
-/**
- * SECOND OPINION SURGERY - Services requested to support second opinion on surgery. */
- | "A9"
-/**
- * ABORTION PERFORMED DUE TO RAPE - Code indicates abortion performed due to a rape. */
- | "AA"
-/**
- * ABORTION PERFORMED DUE TO INCEST - Code indicates abortion performed due to an incident of incest. */
- | "AB"
-/**
- * ABORTION PERFORMED DUE TO SERIOUS FETAL GENETIC DEFECT, DEFORMITY, OR ABNORMALITY - Code indicates abortion performed due to a genetic defect, a deformity, or abnormality to the fetus. */
- | "AC"
-/**
- * ABORTION PERFORMED DUE TO A LIFE ENDANGERING PHYSICAL CONDITION - Abortion performed due to a life endangering physical condition caused by, or, arising from or exacerbated by the pregnancy itself. */
- | "AD"
-/**
- * ABORTION PERFORMED DUE TO PHYSICAL HEALTH OF MOTHER THAT IS NOT LIFE ENDANGERING - Abortion performed due to physical health of mother that is not life endangering. */
- | "AE"
-/**
- * ABORTION PERFORMED DUE TO EMOTIONAL/PSYCHOLOGICAL HEALTH OF THE MOTHER - Abortion performed due to emotional psychological health of the mother. */
- | "AF"
-/**
- * ABORTION PERFORMED DUE TO SOCIAL OR ECONOMIC REASONS - Abortion performed due to social or economic reasons. */
- | "AG"
-/**
- * ELECTIVE ABORTION - Elective abortion. */
- | "AH"
-/**
- * STERILIZATION - Sterilization. */
- | "AI"
-/**
- * PAYER RESPONSIBLE FOR CO-PAYMENT - Payer responsible for co-payment. */
- | "AJ"
-/**
- * AIR AMBULANCE REQUIRED - For ambulance claims. Air ambulance required; time needed to transport poses a threat. */
- | "AK"
-/**
- * SPECIALIZED TREATMENT/BED UNAVAILABLE - ALTERNATE FACILITY TRANSPORT - For ambulance claims. Specialized treatment bed unavailable. Transport to alternate facility. */
- | "AL"
-/**
- * NON-EMERGENCY MEDICALLY NECESSARY STRETCHER TRANSPORT REQUIRED - For ambulance claims. Non-emergency medically necessary stretcher transport required. */
- | "AM"
-/**
- * PREADMISSION SCREENING NOT REQUIRED - Person meets the criteria for an exemption from preadmission screening. */
- | "AN"
-/**
- * MEDICARE COORDINATED CARE DEMONSTRATION CLAIM - Patient is participant in the Medicare Coordinated Care Demonstration. */
- | "B0"
-/**
- * BENEFICIARY IS INELIGIBLE FOR DEMONSTRATION PROGRAM - Beneficiary is ineligible for demonstration program. */
- | "B1"
-/**
- * CRITICAL ACCESS HOSPITAL AMBULANCE ATTESTATION - Attestation by Critical Access Hospital that it meets the criteria for exemption from the ambulance fee schedule. */
- | "B2"
-/**
- * PREGNANCY INDICATOR - Indicates patient is pregnant. Required when mandated by law; determination of pregnancy completed in compliance with applicable law. */
- | "B3"
-/**
- * ADMISSION UNRELATED TO DISCHARGE ON SAME DAY - Report code when a patient is discharged/transferred from an acute care PPS hospital on the same day for symptoms unrelated to and/or not for evaluation and management of, the prior stay’s medical condition. */
- | "B4"
-/**
- * GULF OIL SPILL OF 2010 (EFFECTIVE 4/20/10) - This code identifies claims where the provision of all services on the claim are related, in whole or in part, to an illness, injury, or condition that was caused by or exacerbated by the effects, direct or indirect, of the 2010 oil spill in the Gulf of Mexico and/or circumstances related to such spill, including but not limited to subsequent clean-up activities. */
- | "BP"
-/**
- * APPROVED AS BILLED - The services provided for this billing period have been reviewed by the QIO or intermediary, as appropriate, and are fully approved including any day or cost outlier. */
- | "C1"
-/**
- * AUTOMATIC APPROVAL AS BILLED BASED ON FOCUSED REVIEW - This should include only categories of cases that the QIO has determined it need not review under a focused review program. (No longer used for Medicare.) */
- | "C2"
-/**
- * PARTIAL APPROVAL - The services provided for this billing period have been reviewed by the QIO or intermediary, as appropriate, and some portion has been denied (days, or services). */
- | "C3"
-/**
- * ADMISSION/SERVICES DENIED - This should only be used to indicate that all of the services were denied by the QIO. */
- | "C4"
-/**
- * POST PAYMENT REVIEW APPLICABLE - This should be used indicated that the QIO review will take place after payment. */
- | "C5"
-/**
- * ADMISSION PREAUTHORIZATION - The QIO authorized this admission/service but has not reviewed the services provided. */
- | "C6"
-/**
- * EXTENDED AUTHORIZATION - The QIO has authorized these services for an extended length of time but has not reviewed the services provided. */
- | "C7"
-/**
- * CHANGES TO SERVICE DATES - Changes to service dates. */
- | "D0"
-/**
- * CHANGES TO CHARGES - Changes to charges. */
- | "D1"
-/**
- * CHANGES IN REVENUE CODES/HCPCS/HIPPS RATE CODES - Report this claim change reason code on a replacement claim (Bill Type Frequency Code 7) to reflect a change in Revenue Codes (FL42) HCPCS/HIPPS Rate Codes (FL44). */
- | "D2"
-/**
- * SECOND OR SUBSEQUENT INTERIM PPS BILL - Second or subsequent Interim PPS bill. */
- | "D3"
-/**
- * CHANGE IN CLINICAL CODES (ICD) FOR DIAGNOSIS AND/OR PROCEDURE CODES - Report this claim change reason code on a replacement claim (Bill Type Frequency Code 7) to reflect a change in diagnosis (FL67) and procedure codes (FL74). */
- | "D4"
-/**
- * CANCEL TO CORRECT INSURED’S ID OR PROVIDER ID - Cancel only to correct insured’s ID or provider identification number. */
- | "D5"
-/**
- * CANCEL ONLY TO REPAY A DUPLICATE OR OIG OVERPAYMENT - Cancel only to repay a duplicate payment or OIG overpayment. (Includes cancellation of an
- * outpatient bill containing services required to be included on the inpatient bill.) */
- | "D6"
-/**
- * CHANGE TO MAKE MEDICARE THE SECONDARY PAYER - Change to make Medicare the secondary payer. */
- | "D7"
-/**
- * CHANGE TO MAKE MEDICARE THE PRIMARY PAYER - Change to make Medicare the primary payer. */
- | "D8"
-/**
- * ANY OTHER CHANGE - Any other change. */
- | "D9"
-/**
- * DISASTER RELATED - Used to identify claims that are or may be impacted by specific payer/health plan policies related to a national or regional disaster. */
- | "DR(a)"
-/**
- * CHANGE IN PATIENT STATUS - Change in patient status. */
- | "E0"
-/**
- * DISTINCT MEDICAL VISIT - Report this code when multiple medical visits occurred on the same day in the same revenue center but the visits were distinct and constituted independent visits. An example of such a situation would be a beneficiary going to the emergency room twice on the same day, in the morning for a broken arm and later for chest pain. */
- | "G0"
-/**
- * DELAYED FILING; STATEMENT OF INTENT SUBMITTED - Code indicates submission of “Statement of Intent” within the qualifying period to specifically identify the existence of another third party liability situation. */
- | "H0"
-/**
- * DISCHARGE BY A HOSPICE PROVIDER FOR CAUSE (EFFECTIVE 1/1/09) - Discharge by a hospice provider for cause. */
- | "H2"
-/**
- * REOCCURRENCE OF GI BLEED COMORBID CATEGORY (EFFECTIVE 1/1/11) - Code indicates a reoccurrence of GI bleed comorbid category limited for use in conjunction with ESRD PPS and applicable to 072x types of bill only. */
- | "H3"
-/**
- * REOCCURRENCE OF PNEUMONIA COMORBID CATEGORY (EFFECTIVE 1/1/11) - Code indicates a reoccurrence of pneumonia comorbid category limited for use in conjunction with ESRD PPS and applicable to 072x types of bill only. */
- | "H4"
-/**
- * REOCCURRENCE OF PERICARDITIS COMORBID CATEGORY (EFFECTIVE 1/1/11) - Code indicates a reoccurrence of pericarditis comorbid category limited for use in conjunction with ESRD PPS and applicable to 072x types of bill only. */
- | "H5"
-/**
- * DO NOT RESUSCITATE ORDER (DNR) - FOR PUBLIC HEALTH DATA REPORTING ONLY when required by state or federal law or regulations. Code indicates that a DNR order was written at the time of or within the first 24 hours of the patient’s admission to the hospital and is clearly documented in the patient’s medical record. */
- | "P1"
-/**
- * DIRECT INPATIENT ADMISSION FROM EMERGENCY ROOM (EFFECTIVE 7/1/10) - FOR PUBLIC HEALTH DATA REPORTING ONLY when required by state or federal law or regulations. Code indicates that patient was admitted directly from this facility’s Emergency Room/Department. */
- | "P7"
-/**
- * REQUEST FOR REOPENING REASON CODE - MATHEMATICAL OR COMPUTATIONAL MISTAKES (EFFECTIVE 1/1/16) - Mathematical or computational mistakes. */
- | "R1"
-/**
- * REQUEST FOR REOPENING REASON CODE - INACCURATE DATA ENTRY (EFFECTIVE 1/1/16) - Inaccurate data entry, e.g., miskeyed or transposed provider number, referring NPI, date of service, procedure code, etc. */
- | "R2"
-/**
- * REQUEST FOR REOPENING REASON CODE - MISAPPLICATION OF A FEE SCHEDULE (EFFECTIVE 1/1/16) - Misapplication of a fee schedule. */
- | "R3"
-/**
- * REQUEST FOR REOPENING REASON CODE - COMPUTER ERRORS (EFFECTIVE 1/1/16) - Computer errors. */
- | "R4"
-/**
- * REQUEST FOR REOPENING REASON CODE - INCORRECTLY IDENTIFIED DUPLICATE CLAIM (EFFECTIVE 1/1/16) - Claims denied as duplicates which the party believes were incorrectly identified as a duplicate. */
- | "R5"
-/**
- * REQUEST FOR REOPENING REASON CODE - OTHER CLERICAL ERRORS OR MINOR ERRORS AND OMISSIONS NOT SPECIFIED IN R1-R5 ABOVE (EFFECTIVE 1/1/16) - Other clerical errors or minor errors and omissions not specified in R1-R5 above. */
- | "R6"
-/**
- * REQUEST FOR REOPENING REASON CODE - CORRECTIONS OTHER THAN CLERICAL ERRORS (EFFECTIVE 1/1/16) - Claim corrections other than clerical errors within one year of the date of initial determination. */
- | "R7"
-/**
- * REQUEST FOR REOPENING REASON CODE - NEW AND MATERIAL EVIDENCE (EFFECTIVE 1/1/16) - A reopening for good cause (one to four years from the date of the initial determination) due to new and material evidence that was not available or known at the time of the determination or decision and may result in a different conclusion. */
- | "R8"
-/**
- * REQUEST FOR REOPENING REASON CODE - FAULTY EVIDENCE (EFFECTIVE 1/1/16) - A reopening for good cause (one to four years from the date of the initial determination) because the evidence that was considered in making the determination or decision clearly shows that an obvious error was made at the time of the determination or decision. */
- | "R9"
-/**
- * UNITED MINE WORKERS OF AMERICA (UMWA) DEMONSTRATION INDICATOR - Used for United Mine Workers of America (UMWA) demonstration indicator ONLY. */
- | "W0"
-/**
- * DUPLICATE OF ORIGINAL BILL (EFFECTIVE 10/1/08) - Code indicates bill is exact duplicate of the original bill submitted. */
- | "W2"
-/**
- * LEVEL I APPEAL (EFFECTIVE 10/1/08) - Code indicates bill is submitted for reconsideration; the level of appeal / reconsideration (I) is specified/defined by the payer. */
- | "W3"
-/**
- * LEVEL II APPEAL (EFFECTIVE 10/1/08) - Code indicates bill is submitted for reconsideration; the level of appeal / reconsideration (II) is specified/defined by the payer. */
- | "W4"
-/**
- * LEVEL III APPEAL (EFFECTIVE 10/1/08) - Code indicates bill is submitted for reconsideration; the level of appeal / reconsideration (II) is specified/defined by the payer. */
- | "W5";
 export declare const ConditionCode: {
+    /**
+     * MILITARY SERVICE RELATED - Medical condition incurred during military service. */
     readonly C01: "01";
+    /**
+     * CONDITION IS EMPLOYMENT RELATED - Patient alleges that medical condition is due to environment/events resulting from employment. */
     readonly C02: "02";
+    /**
+     * PATIENT COVERED BY INSURANCE NOT REFLECTED HERE - Indicates that patient/patient representative has stated that coverage may exist beyond that reflected on this bill. */
     readonly C03: "03";
+    /**
+     * INFORMATION ONLY BILL - Indicates submission of bill is for informational purposes only. Examples would include a bill submitted as a utilization report, or a bill for a beneficiary who enrolled in a risk-based managed care plan and the hospital expects to receive payment from the plan. */
     readonly C04: "04";
+    /**
+     * LIEN HAS BEEN FILED - Provider has filed legal claim for recovery of funds potentially due a patient resulting from legal action initiated by or on behalf of the patient. */
     readonly C05: "05";
+    /**
+     * ESRD PATIENT IN FIRST 30 MONTHS OF ENTITLEMENT COVERED BY EMPLOYER GROUP HEALTH INSURANCE - Code indicates Medicare as the secondary insurer because the patient also is covered through an employer group health insurance during his first 30 months of End Stage Renal Disease (ESRD) entitlement. */
     readonly C06: "06";
+    /**
+     * TREATMENT OF NON-TERMINAL CONDITION FOR HOSPICE PATIENT - Code indicates the patient is a hospice enrollee, but the provider is not treating his terminal condition and is therefore, requesting regular Medicare reimbursement. */
     readonly C07: "07";
+    /**
+     * BENEFICIARY WOULD NOT PROVIDE INFORMATION CONCERNING OTHER INSURANCE COVERAGE - Enter this code if the beneficiary would not provide information concerning other insurance coverage. */
     readonly C08: "08";
+    /**
+     * NEITHER PATIENT NOR SPOUSE IS EMPLOYED - Indicates that in response to development questions, the patient and spouse (if the patient is married) have denied any employment. */
     readonly C09: "09";
+    /**
+     * PATIENT AND/OR SPOUSE IS EMPLOYED BUT NO EGHP EXISTS - Code indicates that in response to development questions, the patient and/or spouse have indicated that one is or both are employed but have no group health insurance from an EGHP or other employer sponsored or provided health insurance that covers the patient. */
     readonly C10: "10";
+    /**
+     * DISABLED BENEFICIARY BUT NO LGHP - Code indicates that in response to development questions, the disabled beneficiary and/or family members have indicated that one is or more are employed but have no group health insurance from an LGHP or other employer sponsored or provided health insurance that covers the patient. */
     readonly C11: "11";
+    /**
+     * PATIENT IS HOMELESS - The patient is homeless. */
     readonly C17: "17";
+    /**
+     * MAIDEN NAME RETAINED - A dependent spouse entitled to benefits who does not use her husband's last name. */
     readonly C18: "18";
+    /**
+     * CHILD RETAINS MOTHER'S NAME - A patient who is a dependent child entitled to benefits and does not have its father's last name. */
     readonly C19: "19";
+    /**
+     * BENEFICIARY REQUESTED BILLING - Provider realizes services are non-covered level of care or excluded, but beneficiary requests determination by payer. (Currently limited to home health and inpatient SNF claims.) */
     readonly C20: "20";
+    /**
+     * BILLING FOR DENIAL NOTICE - Provider realizes services are non-covered level of care or excluded, but requests notice from Medicare or other payer. */
     readonly C21: "21";
+    /**
+     * PATIENT ON MULTIPLE DRUG REGIMEN - A patient who is receiving multiple intravenous drugs while on home IV therapy. */
     readonly C22: "22";
+    /**
+     * HOME CARE GIVER AVAILABLE - The patient has a caregiver available to assist him or her during self-administration of an intravenous drug. */
     readonly C23: "23";
+    /**
+     * HOME IV PATIENT ALSO RECEIVING HHA SERVICES - The patient is under the care of Home Health Agency while receiving home IV drug therapy services. */
     readonly C24: "24";
+    /**
+     * PATIENT IS NON-U.S. RESIDENT - The patient is not a resident of the United States. */
     readonly C25: "25";
+    /**
+     * VA ELIGIBLE PATIENT CHOOSES TO RECEIVE SERVICES IN A MEDICARE CERTIFIED FACILITY - Indicates that the patient is a VA eligible patient and chooses to receive services in a Medicare certified provider instead of a VA facility. */
     readonly C26: "26";
+    /**
+     * PATIENT REFERRED TO A SOLE COMMUNITY HOSPITAL FOR A DIAGNOSTIC LABORATORY TEST - To be reported by Sole Community hospitals only. Report this code to indicate the patient was referred for a diagnostic laboratory test. Do not report this code when a specimen only is referred. */
     readonly C27: "27";
+    /**
+     * PATIENT AND/OR SPOUSE’S EGHP IS SECONDARY TO MEDICARE - Code indicates that in response to development questions, the patient and/or spouse have indicated that one is or both are employed and that there is group health insurance from an EGHP or other employer sponsored or provided health insurance that covers the patient but that either: (1) the EGHP is a single employer plan and the employer has fewer than 20 full and part-time employees; or, (2) the EGHP is a multi or multiple employer plan that elects to pay secondary to Medicare for employees and spouses aged 65 and older for those participating employers who have fewer than 20 employees. */
     readonly C28: "28";
+    /**
+     * DISABLED BENEFICIARY AND/OR FAMILY MEMBER’S LGHP IS SECONDARY TO MEDICARE - Code indicates that in response to development questions, the patient and/or family member(s) have indicated that one is or more are employed. There also is group health insurance coverage from a LGHP or other employer sponsored or provided health insurance that covers the patient. Generally, (1) the LGHP is a single employer plan and that the employer has fewer than 100 full and part-time employees; or, (2), the LGHP is a multiple employer plan and that all employers participating in the plan have fewer than 100 full and part-time employees. */
     readonly C29: "29";
+    /**
+     * QUALIFYING CLINICAL TRIALS - Non-research services provided to patients enrolled in a Qualified Clinical Trial. */
     readonly C30: "30";
+    /**
+     * PATIENT IS STUDENT (FULL TIME - DAY) - Patient declares that he or she is enrolled as a full time day student. */
     readonly C31: "31";
+    /**
+     * PATIENT IS STUDENT (COOPERATIVE/ WORK STUDY PROGRAM) - Self-explanatory. */
     readonly C32: "32";
+    /**
+     * PATIENT IS STUDENT (FULL TIME - NIGHT) - Patient declares that he or she is enrolled as a full time night student. */
     readonly C33: "33";
+    /**
+     * PATIENT IS STUDENT (PART TIME) - Patient declares that he or she is enrolled as a part time student. */
     readonly C34: "34";
+    /**
+     * PACE ELIGIBLE PATIENT DISENROLLS DURING AN INPATIENT ADMISSION - Indicates that the patient is a PACE eligible patient that has disenrolled from PACE during an inpatient admission. */
     readonly C35: "35";
+    /**
+     * GENERAL CARE PATIENT IN A SPECIAL UNIT - Patient temporarily placed in special care unit bed because no general care beds available. */
     readonly C36: "36";
+    /**
+     * WARD ACCOMMODATION AT PATIENT REQUEST - Patient assigned to ward accommodations at patient’s request. */
     readonly C37: "37";
+    /**
+     * SEMI-PRIVATE ROOM NOT AVAILABLE - Indicates that either private or ward accommodations were assigned because semi- private accommodations were not available. */
     readonly C38: "38";
+    /**
+     * PRIVATE ROOM MEDICALLY NECESSARY - Patient needs a private room for medical requirements. */
     readonly C39: "39";
+    /**
+     * SAME DAY TRANSFER - Patient transferred to another facility before midnight on the day of admission. */
     readonly C40: "40";
+    /**
+     * PARTIAL HOSPITALIZATION - Indicates claim is for partial hospitalization services. */
     readonly C41: "41";
+    /**
+     * CONTINUING CARE NOT RELATED TO INPATIENT HOSPITALIZATION - Continuing care not related to the condition or diagnosis for which the individual received inpatient hospital services. */
     readonly C42: "42";
+    /**
+     * CONTINUING CARE NOT PROVIDED WITHIN PRESCRIBED POST-DISCHARGE WINDOW - Continuing care related to the inpatient admission but the prescribed care was not provided within the post-discharge window. */
     readonly C43: "43";
+    /**
+     * INPATIENT ADMISSION CHANGED TO OUTPATIENT - For use on outpatient claims only, when the physician ordered inpatient services, but upon internal utilization review performed before the claim was originally submitted, the hospital determined that the services did not meet its inpatient criteria. (Note: For Medicare, the change in patient status from inpatient to outpatient is made prior to discharge or release, while the beneficiary is still a patient of the hospital.) */
     readonly C44: "44";
+    /**
+     * GENDER INCONGRUENCE - Characterized by a marked and persistent incongruence between an individual's experienced gender and the sex at birth. */
     readonly C45: "45";
+    /**
+     * NON-AVAILABILITY STATEMENT ON FILE - A non-availability statement must be issued for each TRICARE claim for non-emergency inpatient care when the TRICARE beneficiary resides within the catchment’s area (usually a 40-mile radius) of a Uniformed Services Hospital. */
     readonly C46: "46";
+    /**
+     * TRANSFER FROM ANOTHER HOME HEALTH AGENCY (EFFECTIVE 7/1/10) - The patient was admitted to this home health agency as a transfer from another home health agency. */
     readonly C47: "47";
+    /**
+     * PSYCHIATRIC RESIDENTIAL TREATMENT CENTERS FOR CHILDREN AND ADOLESCENTS (RTCS) - Code to identify claims submitted by a “TRICARE - authorized” psychiatric Residential Treatment Center (RTC) for Children and Adolescents. */
     readonly C48: "48";
+    /**
+     * PRODUCT REPLACEMENT WITHIN PRODUCT LIFECYCLE (EFFECTIVE 1/1/15) - Replacement of a product earlier than the anticipated lifecycle. */
     readonly C49: "49";
+    /**
+     * PRODUCT REPLACEMENT FOR KNOWN RECALL OF A PRODUCT - Manufacturer or FDA has identified the product for recall and therefore replacement. */
     readonly C50: "50";
+    /**
+     * ATTESTATION OF UNRELATED OUTPATIENT NONDIAGNOSTIC SERVICES (EFFECTIVE 4/1/11) - The hospital attests that the outpatient nondiagnostic service provided within 3 calendars days (1 calendar day for non-subsection (d) hospitals) prior to the admission is not related to the admission to the inpatient stay. For use on outpatient claims only. */
     readonly C51: "51";
+    /**
+     * OUT OF HOSPICE SERVICE AREA (EFFECTIVE 7/1/12) - Code used when the patient is discharged for moving out of the hospice service area, including patients admitted to a hospital without contractual arrangements with the hospice. */
     readonly C52: "52";
+    /**
+     * INITIAL PLACEMENT OF A MEDICAL DEVICE PROVIDED AS PART OF A CLINICAL TRIAL OR A FREE SAMPLE. (EFFECTIVE 7/1/15) - Code is for outpatient claims that have received a device credit upon initial medical device placement in a clinical trial or a free sample. */
     readonly C53: "53";
+    /**
+     * NO SKILLED HOME HEALTH VISITS IN BILLING PERIOD. POLICY EXCEPTION DOCUMENTED AT THE HOME HEALTH AGENCY (EFFECTIVE 7/1/16) - Report when the Home Health claim is submitted without any skilled visits due to a circumstance that is allowed by the payer and indicate that the policy exception is documented at the Home Health Agency. */
     readonly C54: "54";
+    /**
+     * SNF BED NOT AVAILABLE - Code indicates the patient’s SNF admission was delayed more than 30 days after hospital discharge because a SNF bed was not available. */
     readonly C55: "55";
+    /**
+     * MEDICAL APPROPRIATENESS - Code indicates the patient’s SNF admission was delayed more than 30 days after hospital discharge because his condition made it inappropriate to begin active care within that period. */
     readonly C56: "56";
+    /**
+     * SNF READMISSION - Code indicates the patient was previously receiving Medicare covered SNF care within 30 days of this readmission. */
     readonly C57: "57";
+    /**
+     * TERMINATED MEDICARE ADVANTAGE ENROLLEE - Code indicates that patient is a terminated enrollee in a Medicare Advantage plan whose three-day inpatient hospital stay was waived. */
     readonly C58: "58";
+    /**
+     * NON-PRIMARY ESRD FACILITY - Code indicates that ESRD beneficiary received non- scheduled or emergency dialysis services at a facility other than his/her primary ESRD dialysis facility. */
     readonly C59: "59";
+    /**
+     * DAY OUTLIER - A hospital being paid under a prospective payment system is reporting this stay as a day outlier. */
     readonly C60: "60";
+    /**
+     * COST OUTLIER - A hospital being paid under a prospective payment system is requesting additional payment for this stay as a cost outlier. */
     readonly C61: "61";
+    /**
+     * PROVIDER DOES NOT WISH COST OUTLIER PAYMENT - A hospital paid under a prospective payment system is NOT requesting additional payment for this stay as a cost outlier. */
     readonly C66: "66";
+    /**
+     * BENEFICIARY ELECTS NOT TO USE LIFE TIME RESERVE (LTR) DAYS - Indicates beneficiary elects not to use LTR days. */
     readonly C67: "67";
+    /**
+     * BENEFICIARY ELECTS TO USE LIFE TIME RESERVE (LTR) DAYS - Indicates beneficiary has elected to use LTR days when charges are less than LTR co-insurance amounts. */
     readonly C68: "68";
+    /**
+     * IME/DGME/N&AH PAYMENT ONLY - Code indicates a request for a supplemental payment for IME/DGME/N&AH (Indirect Medical Education/Graduate Medical Education/ Nursing and Allied Health). */
     readonly C69: "69";
+    /**
+     * SELF-ADMINISTERED ANEMIA MANAGEMENT DRUG - Code indicates the billing is for a home dialysis patient who self administers an anemia management drug, such as erythropoietin alpha (EPO) or darbepoetin alpha. */
     readonly C70: "70";
+    /**
+     * FULL CARE IN UNIT - Code indicates the billing is for a patient who received staff-assisted dialysis services in a hospital or renal dialysis facility. */
     readonly C71: "71";
+    /**
+     * SELF CARE IN UNIT - Code indicates the billing is for a patient who managed his own dialysis services without staff assistance in a hospital or renal dialysis facility. */
     readonly C72: "72";
+    /**
+     * ESRD SELF CARE TRAINING - Code indicates the billing is for special dialysis services training when a patient or caregiver is learning to perform dialysis. */
     readonly C73: "73";
+    /**
+     * HOME - Code indicates the billing is for a patient who received dialysis services at home, but where code 75 below does not apply. */
     readonly C74: "74";
+    /**
+     * HOME - 100 PERCENT REIMBURSEMENT - Code indicates the billing is for a patient who received dialysis services at home, using a dialysis machine that was purchased by Medicare under the 100 percent program. */
     readonly C75: "75";
+    /**
+     * BACK-UP IN FACILITY DIALYSIS - Code indicates the billing is for a home dialysis patient who received back-up dialysis in a facility. */
     readonly C76: "76";
+    /**
+     * PROVIDER ACCEPTS OR IS OBLIGATED/REQUIRED DUE TO A CONTRACTUAL ARRANGEMENT OR LAW TO ACCEPT PAYMENT BY A PRIMARY PAYER AS PAYMENT IN FULL. - Code indicates you have accepted or are
+     * obligated/required due to a contractual
+     * arrangement or law to accept payment as
+     * payment in full. Therefore, no payment is due. */
     readonly C77: "77";
+    /**
+     * NEW COVERAGE NOT IMPLEMENTED BY MANAGED CARE PLAN - Billing is for a newly covered service for which
+     * the managed care plan/HMO does not pay. (Note:
+     * For outpatient bills Condition Code 04 should be
+     * omitted). */
     readonly C78: "78";
+    /**
+     * CORF SERVICES PROVIDED OFFSITE - Enter this code to indicate that physical therapy,
+     * occupational therapy, or speech pathology ser-
+     * vices were provided offsite. */
     readonly C79: "79";
+    /**
+     * HOME DIALYSIS - NURSING FACILITY - Home dialysis furnished in a SNF or nursing facility. */
     readonly C80: "80";
+    /**
+     * C-SECTIONS/INDUCTIONS < 39 WEEKS - MEDICAL NECESSITY - C-sections or inductions performed at less than 39 weeks gestation for medical necessity. */
     readonly C81: "81";
+    /**
+     * C-SECTIONS/INDUCTIONS < 39 WEEKS - ELECTIVE - C-sections or inductions performed at less than 39 weeks gestation electively. */
     readonly C82: "82";
+    /**
+     * C-SECTIONS/INDUCTIONS 39 WEEKS OR GREATER - C-sections or inductions performed at 39 weeks gestation or greater. */
     readonly C83: "83";
+    /**
+     * DIALYSIS FOR ACUTE KIDNEY INJURY (AKI) (EFFECTIVE 1/1/17) - Dialysis facilities (Type of Bill 072x) enter this code to indicate that the billing is for a patient with AKI. (Not to be used for patients with End Stage Renal Disease) */
     readonly C84: "84";
+    /**
+     * DELAYED RECERTIFICATION OF HOSPICE TERMINAL ILLNESS (EFFECTIVE 1/1/17) - Used when hospice recertification is untimely. */
     readonly C85: "85";
+    /**
+     * ADDITIONAL HEMODIALYSIS TREATMENTS WITH MEDICAL JUSTIFICATION (ORIGINAL EFFECTIVE DATE DELAYED. NEW EFFECTIVE DATE TBD*) - Enter this code to indicate that the billing is for a patient receiving hemodialysis who exhibits a medical condition that necessitates hemodialysis at a frequency greater than the patient’s plan of care and all treatments on the claim are reasonable and necessary. */
     readonly C86: "86";
+    /**
+     * ESRD SELF CARE RETRAINING (EFFECTIVE 7/1/17) - Code indicates the billing is for special dialysis services retraining where the patient or caregiver has previously completed dialysis training. */
     readonly C87: "87";
+    /**
+     * ALLOGENEIC STEM CELL TRANSPLANT RELATED DONOR CHARGES (EFFECTIVE 7/1/20) - Claim submitted is solely for separately billed charges for evaluating related stem cell transplant donor candidates prior to the actual transplant claim. */
     readonly C88: "88";
+    /**
+     * OPIOID TREATMENT PROGRAM (EFFECTIVE 1/1/21) - Indicates claim is for opioid treatment program services. */
     readonly C89: "89";
+    /**
+     * EXPANDED ACCESS APPROVAL (EFFECTIVE 2/1/21) - Service provided as part of an Expanded Access approval. */
     readonly C90: "90";
+    /**
+     * EMERGENCY USE AUTHORIZATION (EFFECTIVE 2/1/21) - Service provided as part of an Emergency Use Authorization. */
     readonly C91: "91";
+    /**
+     * INTENSIVE OUTPATIENT PROGRAM (IOP) (EFFECTIVE FOR SERVICES FURNISHED ON OR AFTER 1/1/2024) - Code indicates claim is for Intensive Outpatient Services */
     readonly C92: "92";
+    /**
+     * TRICARE EXTERNAL PARTNERSHIP PROGRAM - This code identifies TRICARE claims submitted under the External Partnership Program. */
     readonly Ca0: "A0";
+    /**
+     * BIRTH DATE - INSURED A - The birth date of the individual in whose name the insurance is carried. */
     readonly Ca1: "A1";
+    /**
+     * PHYSICALLY HANDICAPPED CHILDREN’S PROGRAM - Services provided under this program receive special funding through Title VII of the Social Security Act or the TRICARE program for the Handicapped. */
     readonly Ca2: "A2";
+    /**
+     * SPECIAL FEDERAL FUNDING - This code has been designed for uniform use as defined by state law. */
     readonly Ca3: "A3";
+    /**
+     * FAMILY PLANNING - This code has been designed for uniform use as defined by state law. */
     readonly Ca4: "A4";
+    /**
+     * DISABILITY - This code has been designed for uniform use as defined by state law. */
     readonly Ca5: "A5";
+    /**
+     * VACCINES/MEDICARE 100% PAYMENT - This code identifies that pneumococcal pneumonia and influenza vaccine services are reimbursed under special Medicare program provisions and Medicare deductible and coinsurance requirements do not apply. */
     readonly Ca6: "A6";
+    /**
+     * HOSPITAL SERVICES PROVIDED IN A MOBILE FACILITY OR WITH PORTABLE UNITS (EFFECTIVE 4/1/20). - Code indicates that hospital services were provided in a mobile facility or with portable units. */
     readonly Ca7: "A7";
+    /**
+     * SECOND OPINION SURGERY - Services requested to support second opinion on surgery. */
     readonly Ca9: "A9";
+    /**
+     * ABORTION PERFORMED DUE TO RAPE - Code indicates abortion performed due to a rape. */
     readonly Caa: "AA";
+    /**
+     * ABORTION PERFORMED DUE TO INCEST - Code indicates abortion performed due to an incident of incest. */
     readonly Cab: "AB";
+    /**
+     * ABORTION PERFORMED DUE TO SERIOUS FETAL GENETIC DEFECT, DEFORMITY, OR ABNORMALITY - Code indicates abortion performed due to a genetic defect, a deformity, or abnormality to the fetus. */
     readonly Cac: "AC";
+    /**
+     * ABORTION PERFORMED DUE TO A LIFE ENDANGERING PHYSICAL CONDITION - Abortion performed due to a life endangering physical condition caused by, or, arising from or exacerbated by the pregnancy itself. */
     readonly Cad: "AD";
+    /**
+     * ABORTION PERFORMED DUE TO PHYSICAL HEALTH OF MOTHER THAT IS NOT LIFE ENDANGERING - Abortion performed due to physical health of mother that is not life endangering. */
     readonly Cae: "AE";
+    /**
+     * ABORTION PERFORMED DUE TO EMOTIONAL/PSYCHOLOGICAL HEALTH OF THE MOTHER - Abortion performed due to emotional psychological health of the mother. */
     readonly Caf: "AF";
+    /**
+     * ABORTION PERFORMED DUE TO SOCIAL OR ECONOMIC REASONS - Abortion performed due to social or economic reasons. */
     readonly Cag: "AG";
+    /**
+     * ELECTIVE ABORTION - Elective abortion. */
     readonly Cah: "AH";
+    /**
+     * STERILIZATION - Sterilization. */
     readonly Cai: "AI";
+    /**
+     * PAYER RESPONSIBLE FOR CO-PAYMENT - Payer responsible for co-payment. */
     readonly Caj: "AJ";
+    /**
+     * AIR AMBULANCE REQUIRED - For ambulance claims. Air ambulance required; time needed to transport poses a threat. */
     readonly Cak: "AK";
+    /**
+     * SPECIALIZED TREATMENT/BED UNAVAILABLE - ALTERNATE FACILITY TRANSPORT - For ambulance claims. Specialized treatment bed unavailable. Transport to alternate facility. */
     readonly Cal: "AL";
+    /**
+     * NON-EMERGENCY MEDICALLY NECESSARY STRETCHER TRANSPORT REQUIRED - For ambulance claims. Non-emergency medically necessary stretcher transport required. */
     readonly Cam: "AM";
+    /**
+     * PREADMISSION SCREENING NOT REQUIRED - Person meets the criteria for an exemption from preadmission screening. */
     readonly Can: "AN";
+    /**
+     * MEDICARE COORDINATED CARE DEMONSTRATION CLAIM - Patient is participant in the Medicare Coordinated Care Demonstration. */
     readonly Cb0: "B0";
+    /**
+     * BENEFICIARY IS INELIGIBLE FOR DEMONSTRATION PROGRAM - Beneficiary is ineligible for demonstration program. */
     readonly Cb1: "B1";
+    /**
+     * CRITICAL ACCESS HOSPITAL AMBULANCE ATTESTATION - Attestation by Critical Access Hospital that it meets the criteria for exemption from the ambulance fee schedule. */
     readonly Cb2: "B2";
+    /**
+     * PREGNANCY INDICATOR - Indicates patient is pregnant. Required when mandated by law; determination of pregnancy completed in compliance with applicable law. */
     readonly Cb3: "B3";
+    /**
+     * ADMISSION UNRELATED TO DISCHARGE ON SAME DAY - Report code when a patient is discharged/transferred from an acute care PPS hospital on the same day for symptoms unrelated to and/or not for evaluation and management of, the prior stay’s medical condition. */
     readonly Cb4: "B4";
+    /**
+     * GULF OIL SPILL OF 2010 (EFFECTIVE 4/20/10) - This code identifies claims where the provision of all services on the claim are related, in whole or in part, to an illness, injury, or condition that was caused by or exacerbated by the effects, direct or indirect, of the 2010 oil spill in the Gulf of Mexico and/or circumstances related to such spill, including but not limited to subsequent clean-up activities. */
     readonly Cbp: "BP";
+    /**
+     * APPROVED AS BILLED - The services provided for this billing period have been reviewed by the QIO or intermediary, as appropriate, and are fully approved including any day or cost outlier. */
     readonly Cc1: "C1";
+    /**
+     * AUTOMATIC APPROVAL AS BILLED BASED ON FOCUSED REVIEW - This should include only categories of cases that the QIO has determined it need not review under a focused review program. (No longer used for Medicare.) */
     readonly Cc2: "C2";
+    /**
+     * PARTIAL APPROVAL - The services provided for this billing period have been reviewed by the QIO or intermediary, as appropriate, and some portion has been denied (days, or services). */
     readonly Cc3: "C3";
+    /**
+     * ADMISSION/SERVICES DENIED - This should only be used to indicate that all of the services were denied by the QIO. */
     readonly Cc4: "C4";
+    /**
+     * POST PAYMENT REVIEW APPLICABLE - This should be used indicated that the QIO review will take place after payment. */
     readonly Cc5: "C5";
+    /**
+     * ADMISSION PREAUTHORIZATION - The QIO authorized this admission/service but has not reviewed the services provided. */
     readonly Cc6: "C6";
+    /**
+     * EXTENDED AUTHORIZATION - The QIO has authorized these services for an extended length of time but has not reviewed the services provided. */
     readonly Cc7: "C7";
+    /**
+     * CHANGES TO SERVICE DATES - Changes to service dates. */
     readonly Cd0: "D0";
+    /**
+     * CHANGES TO CHARGES - Changes to charges. */
     readonly Cd1: "D1";
+    /**
+     * CHANGES IN REVENUE CODES/HCPCS/HIPPS RATE CODES - Report this claim change reason code on a replacement claim (Bill Type Frequency Code 7) to reflect a change in Revenue Codes (FL42) HCPCS/HIPPS Rate Codes (FL44). */
     readonly Cd2: "D2";
+    /**
+     * SECOND OR SUBSEQUENT INTERIM PPS BILL - Second or subsequent Interim PPS bill. */
     readonly Cd3: "D3";
+    /**
+     * CHANGE IN CLINICAL CODES (ICD) FOR DIAGNOSIS AND/OR PROCEDURE CODES - Report this claim change reason code on a replacement claim (Bill Type Frequency Code 7) to reflect a change in diagnosis (FL67) and procedure codes (FL74). */
     readonly Cd4: "D4";
+    /**
+     * CANCEL TO CORRECT INSURED’S ID OR PROVIDER ID - Cancel only to correct insured’s ID or provider identification number. */
     readonly Cd5: "D5";
+    /**
+     * CANCEL ONLY TO REPAY A DUPLICATE OR OIG OVERPAYMENT - Cancel only to repay a duplicate payment or OIG overpayment. (Includes cancellation of an
+     * outpatient bill containing services required to be included on the inpatient bill.) */
     readonly Cd6: "D6";
+    /**
+     * CHANGE TO MAKE MEDICARE THE SECONDARY PAYER - Change to make Medicare the secondary payer. */
     readonly Cd7: "D7";
+    /**
+     * CHANGE TO MAKE MEDICARE THE PRIMARY PAYER - Change to make Medicare the primary payer. */
     readonly Cd8: "D8";
+    /**
+     * ANY OTHER CHANGE - Any other change. */
     readonly Cd9: "D9";
+    /**
+     * DISASTER RELATED - Used to identify claims that are or may be impacted by specific payer/health plan policies related to a national or regional disaster. */
     readonly CdRa: "DR(a)";
+    /**
+     * CHANGE IN PATIENT STATUS - Change in patient status. */
     readonly Ce0: "E0";
+    /**
+     * DISTINCT MEDICAL VISIT - Report this code when multiple medical visits occurred on the same day in the same revenue center but the visits were distinct and constituted independent visits. An example of such a situation would be a beneficiary going to the emergency room twice on the same day, in the morning for a broken arm and later for chest pain. */
     readonly Cg0: "G0";
+    /**
+     * DELAYED FILING; STATEMENT OF INTENT SUBMITTED - Code indicates submission of “Statement of Intent” within the qualifying period to specifically identify the existence of another third party liability situation. */
     readonly Ch0: "H0";
+    /**
+     * DISCHARGE BY A HOSPICE PROVIDER FOR CAUSE (EFFECTIVE 1/1/09) - Discharge by a hospice provider for cause. */
     readonly Ch2: "H2";
+    /**
+     * REOCCURRENCE OF GI BLEED COMORBID CATEGORY (EFFECTIVE 1/1/11) - Code indicates a reoccurrence of GI bleed comorbid category limited for use in conjunction with ESRD PPS and applicable to 072x types of bill only. */
     readonly Ch3: "H3";
+    /**
+     * REOCCURRENCE OF PNEUMONIA COMORBID CATEGORY (EFFECTIVE 1/1/11) - Code indicates a reoccurrence of pneumonia comorbid category limited for use in conjunction with ESRD PPS and applicable to 072x types of bill only. */
     readonly Ch4: "H4";
+    /**
+     * REOCCURRENCE OF PERICARDITIS COMORBID CATEGORY (EFFECTIVE 1/1/11) - Code indicates a reoccurrence of pericarditis comorbid category limited for use in conjunction with ESRD PPS and applicable to 072x types of bill only. */
     readonly Ch5: "H5";
+    /**
+     * DO NOT RESUSCITATE ORDER (DNR) - FOR PUBLIC HEALTH DATA REPORTING ONLY when required by state or federal law or regulations. Code indicates that a DNR order was written at the time of or within the first 24 hours of the patient’s admission to the hospital and is clearly documented in the patient’s medical record. */
     readonly Cp1: "P1";
+    /**
+     * DIRECT INPATIENT ADMISSION FROM EMERGENCY ROOM (EFFECTIVE 7/1/10) - FOR PUBLIC HEALTH DATA REPORTING ONLY when required by state or federal law or regulations. Code indicates that patient was admitted directly from this facility’s Emergency Room/Department. */
     readonly Cp7: "P7";
+    /**
+     * REQUEST FOR REOPENING REASON CODE - MATHEMATICAL OR COMPUTATIONAL MISTAKES (EFFECTIVE 1/1/16) - Mathematical or computational mistakes. */
     readonly Cr1: "R1";
+    /**
+     * REQUEST FOR REOPENING REASON CODE - INACCURATE DATA ENTRY (EFFECTIVE 1/1/16) - Inaccurate data entry, e.g., miskeyed or transposed provider number, referring NPI, date of service, procedure code, etc. */
     readonly Cr2: "R2";
+    /**
+     * REQUEST FOR REOPENING REASON CODE - MISAPPLICATION OF A FEE SCHEDULE (EFFECTIVE 1/1/16) - Misapplication of a fee schedule. */
     readonly Cr3: "R3";
+    /**
+     * REQUEST FOR REOPENING REASON CODE - COMPUTER ERRORS (EFFECTIVE 1/1/16) - Computer errors. */
     readonly Cr4: "R4";
+    /**
+     * REQUEST FOR REOPENING REASON CODE - INCORRECTLY IDENTIFIED DUPLICATE CLAIM (EFFECTIVE 1/1/16) - Claims denied as duplicates which the party believes were incorrectly identified as a duplicate. */
     readonly Cr5: "R5";
+    /**
+     * REQUEST FOR REOPENING REASON CODE - OTHER CLERICAL ERRORS OR MINOR ERRORS AND OMISSIONS NOT SPECIFIED IN R1-R5 ABOVE (EFFECTIVE 1/1/16) - Other clerical errors or minor errors and omissions not specified in R1-R5 above. */
     readonly Cr6: "R6";
+    /**
+     * REQUEST FOR REOPENING REASON CODE - CORRECTIONS OTHER THAN CLERICAL ERRORS (EFFECTIVE 1/1/16) - Claim corrections other than clerical errors within one year of the date of initial determination. */
     readonly Cr7: "R7";
+    /**
+     * REQUEST FOR REOPENING REASON CODE - NEW AND MATERIAL EVIDENCE (EFFECTIVE 1/1/16) - A reopening for good cause (one to four years from the date of the initial determination) due to new and material evidence that was not available or known at the time of the determination or decision and may result in a different conclusion. */
     readonly Cr8: "R8";
+    /**
+     * REQUEST FOR REOPENING REASON CODE - FAULTY EVIDENCE (EFFECTIVE 1/1/16) - A reopening for good cause (one to four years from the date of the initial determination) because the evidence that was considered in making the determination or decision clearly shows that an obvious error was made at the time of the determination or decision. */
     readonly Cr9: "R9";
+    /**
+     * UNITED MINE WORKERS OF AMERICA (UMWA) DEMONSTRATION INDICATOR - Used for United Mine Workers of America (UMWA) demonstration indicator ONLY. */
     readonly Cw0: "W0";
+    /**
+     * DUPLICATE OF ORIGINAL BILL (EFFECTIVE 10/1/08) - Code indicates bill is exact duplicate of the original bill submitted. */
     readonly Cw2: "W2";
+    /**
+     * LEVEL I APPEAL (EFFECTIVE 10/1/08) - Code indicates bill is submitted for reconsideration; the level of appeal / reconsideration (I) is specified/defined by the payer. */
     readonly Cw3: "W3";
+    /**
+     * LEVEL II APPEAL (EFFECTIVE 10/1/08) - Code indicates bill is submitted for reconsideration; the level of appeal / reconsideration (II) is specified/defined by the payer. */
     readonly Cw4: "W4";
+    /**
+     * LEVEL III APPEAL (EFFECTIVE 10/1/08) - Code indicates bill is submitted for reconsideration; the level of appeal / reconsideration (II) is specified/defined by the payer. */
     readonly Cw5: "W5";
 };
+export type ConditionCode = (typeof ConditionCode)[keyof typeof ConditionCode];