UB Value Codes Sub-Tab

Value codes indicate the code and related dollar amounts that identify monetary data required for processing claims. This information is required for benefit determination. Value codes are two character alpha-numeric codes that print in Field Locators 39-41 on UB claims. You can modify the code and the dollar amount when specific codes and amounts are needed on the UB claim for the encounter.

You can select one Value Code and associated Dollar Amount in rows 39a - 41d, or up to 12 codes and amounts per encounter.

Example: When you select 21 (Catastrophic) in row 31a and enter a dollar amount, the condition code 21 and the amount display in field locator 39a on UB claim forms for the encounter.