NUCC Approves Use of Condition Code DR for Professional Claims for COVID-19 Related Claims, Effective Immediately

 

March 24, 2020

 

The NUCC has approved the use of Condition Code “DR – Disaster Related” effective immediately for COVID-19 related claims on the 1500 Claim Form and in the 837 Professional.  The codes available for use for COVID-19 related claims are:

  • Condition Code DR - Disaster related; Reported at the claim level in Item Number 10d
  • Modifier CR - Catastrophe/disaster related; Reported at the service line level in Item Number 24D 

 

The Centers for Medicare & Medicaid Services (CMS) recently released MLN Matters SE20011 on the use of Condition Code DR and Modifier CR for COVID-19 related Medicare claims.  For Medicare, Condition Code DR is reported only in the institutional claim (electronic ASC X12 837I or paper UB-04).  The NUCC has approved the use of Condition Code DR in the professional claim (electronic ASC X12 837P or paper 1500) due to the business need by other payers to identify COVID-19 related claims, as it can be used to trigger internal payer steps or processing of claims (e.g. a different routing of the claim for processing).

 

The complete list of Condition Codes available for use in the professional claim is available on the Condition Codes page under the Code Sets tab.