61Condition CodePayer-Assigned
This claim involves an unreported operating cost outlier.
Related Payer-Assigned codes
15Processing of this clean claim was delayed by the payer.16This SNF claim is exempt from the standard care transition requirement.60This claim's payment reflects an operating cost day outlier.62This is an unreported periodic interim payment (PIP) bill.63This claim bypasses the Common Working File check for an incarcerated beneficiary.64This claim doesn't meet the definition of a clean claim.65This is an unreported non-PPS hospital bill.EYThis claim is part of a lung volume reduction surgery demonstration study.M0This outpatient claim is billed under an all-inclusive rate.M1This claim reports a vaccine administered through a roster billing arrangement.
Frequently asked questions
What does condition code 61 mean?
This claim involves an unreported operating cost outlier.
What category is condition code 61 in?
61 falls under the Payer-Assigned category of UB-04 condition codes.
Descriptions sourced from CMS Medicare Claims Processing Manual. Always verify codes with authoritative sources before making billing decisions.