Segment HI Patient reason for visit has a note requiring its usage for outpatient visits.
At the same time section 1.12.6 says that UB-04 designations of inpatient/outpatient claims should be used including exceptions. One of the exceptions is for Patient reason for visit limiting requirement to unscheduled outpatient visits but allowing its usage for other outpatient visits.
So should segment Patient reason for visit be required for all outpatient visits or only for unscheduled ones ?
NUBC's Billing Manual specifies the definition of "Unscheduled Outpatient Visits" and under what circumstances this element is required for an outpatient claim within the instructions for Form Locator 70a-c (Patient's Reason for Visit) and Form Locator 04 (Type of Bill). It was the workgroup's intent for this requirement to be designated by the NUBC's Manual, and this direction is clarified in the 5010 guide's front matter sections 1.5 and 1.12.6.