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Wiki CHAMPVA Billing for PHP - Need Guidance on UB-04 Requirements

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sandikoch44

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I’m looking for help from anyone experienced with billing CHAMPVA for Partial Hospitalization Program (PHP) services using the UB-04 form.

We’re receiving denials with the following codes:
  • CO16 – Claim/service lacks information or has submission/billing error(s)
  • M44 – Missing/incomplete/invalid condition code
  • M45 – Missing/incomplete/invalid occurrence code(s)
  • M49 – Missing/incomplete/invalid value code(s) or amount(s)
We’ve tried resubmitting with different condition, occurrence, and value codes, but the denials remain the same.

Does anyone know:
  • Which UB-04 fields CHAMPVA requires for PHP?
  • The correct condition, occurrence, and value codes?
Any insight, examples, or resources would be greatly appreciated!
 
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