Value code

The UB-04 has three value code columns, form locators 39, 40 and 41, each with four lines, a through d. Every entry is a two-character code and an amount of up to nine digits, and only form locator 41 accepts a negative amount. Codes run in ascending numeric order, and the a line of all three columns fills before the b line. Some values are reported as cents and others as whole numbers placed to the left of the dollars and cents delimiter, so each code’s instructions decide the format. The NUBC maintains the list¹.

For a home health agency, value codes set the rate. Medicare pays home health according to where the patient was served, so every claim carries value code 61 with the Core Based Statistical Area number for that location and value code 85 with the FIPS state and county code. If the patient moves during the period, the codes describe the location at the end of it. Other value codes appear only after processing: Medicare adds 17 for an outlier payment, 62 to 65 to split visits and dollars between Part A and Part B, and QF for a late notice of admission penalty. Agencies never submit those².

The mistake is entering a number in the wrong part of the amount field. A CBSA number is not money, but it goes in the dollar portion, right justified, with two zeros in the cents. Typed as cents, it can point the payer to another area or to none. Check each code’s format before the claim leaves.