Multiple Diagnosis Codes for Claim

This reference guide shows the proper way to submit multiple diagnosis codes on a claim for a client when they have multiple diagnoses for services provided. For instructions please see the PDF link below

Considerations:

• These claims need to be submitted in the following format: 837I/UB04 (For Facility, IHS-638, Inpatient, or IOP/PHP Provider types). Diagnosis codes for this type of format are reported on the claim level and are not reported on a service level like other claim formats.
• If the client has more than two diagnosis codes that need to be reported, then the claim will need to contain more than one date of service for the client.

Example of a client with multiple diagnosis codes. One diagnosis code is marked as Primary and Admitting.