As a reminder, when billing for end-stage renal disease (ESRD) services such as dialysis and home health care, the following value codes are required in Form Locator 39-41:
- A8 (Weight in kilograms)
- A9 (Height in centimeters)
- 61 (Core-based statistical area)
- 85 (County code)
Failure to include the required value codes may result in a claims denial.
For additional information and billing requirements, please refer to the Completing a Paper UB-04 Form policy in Harvard Pilgrim Health Care’s Commercial Provider Manual.