Hospital Billing 2nd Edition by Susan Magovern,Jean Jurek

Exercise 6

A working-aged beneficiary had a joint replacement in her left hand.She received a partial payment of $1,150.60 from her employer's benefit plan. The unpaid amount is being submitted to Medicare as the secondary payer. What value code and amount should be reported in FLs 39-41 on the claim?
FL 39 VALUE CODES
Code
Amount
____________
____________. ________