UB04 Condition Codes Code 80: Home Dialysis Nursing Facility

Overview

Condition Code 80, “Home Dialysis Nursing Facility,” is not defined in the provided source documents. The Noridian Condition Codes list (last updated Feb 12, 2026) ends at code 77 and does not include code 80. ^[1] The MassHealth UB‑04 Billing Guide (February 2021) does not list individual condition codes. ^[2] Therefore, no authoritative description or usage guidance for code 80 can be drawn from the supplied references. Providers should consult their specific payer’s condition code manual for the correct definition of code 80.

The Noridian list does contain several dialysis‑related condition codes (70–77) that may be relevant for home dialysis billing scenarios. These are summarized in the Related Codes section below.

When to Use

Because the provided sources do not contain code 80, its appropriate use cannot be stated. For home dialysis services, payers often require a condition code that identifies the dialysis setting. The Noridian list includes codes such as:

• 74 – Billing is for a patient who received dialysis services at home.
• 75 – Billing for home dialysis with machine purchased under 100% payment program.
• 76 – Back‑up dialysis in‑facility.

^[1]

Providers should verify with their fiscal intermediary or Medicare administrative contractor whether code 80 is accepted and what documentation is needed to support it.

Step‑by‑Step Claim Example

No example can be provided for code 80 due to the absence of source data. For illustration, a claim for a patient receiving home dialysis services (not in a nursing facility) might use condition code 74. The following steps would apply:

1. Enter condition code 74 in Form Locator 18–28 (Condition Codes) on the UB‑04.
2. Ensure the patient’s dialysis services were performed at home.
3. Include appropriate revenue codes (e.g., 0820 for home dialysis) and HCPCS codes.
4. Attach any required supporting documentation (e.g., home dialysis training records).

This example is based on code 74 from the Noridian list. ^[1] For code 80, follow the same general process but substitute the correct code and payer‑specific requirements.

Common Mistakes & Audit Red Flags

Without source information for code 80, specific mistakes cannot be identified. However, general audit red flags for condition codes include:

• Using a condition code that does not match the service setting (e.g., using a home dialysis code when the patient was treated in a facility).
• Omitting a required condition code when the payer mandates one for home dialysis.
• Failing to update condition codes when the patient’s dialysis setting changes (e.g., from home to in‑facility).

Providers should always verify that the condition code entered matches the patient’s actual care location and that all payer‑specific edits are satisfied. ^[1]

Related Codes/Fields

The table below lists dialysis‑related condition codes from the Noridian source. Code 80 is included for reference but is not defined in the provided sources.

Code	Meaning	Source
70	Self‑administered EPO (home dialysis)	[1]
71	Full care in unit (dialysis)	[1]
72	Self‑Care in unit (dialysis)	[1]
73	Self‑Care training (dialysis)	[1]
74	Billing is for a patient who received dialysis services at home	[1]
75	Billing for home dialysis with machine purchased under 100% payment program	[1]
76	Back‑up dialysis in‑facility	[1]
77	Provider accepts primary payer payment as pa (incomplete in source)	[1]
80	Home Dialysis Nursing Facility	Not defined in provided sources

Note: The Noridian list ends at code 77. Code 80 is not present in either the Noridian or MassHealth documents supplied. Providers must obtain the correct definition from their own payer’s condition code list.

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References

[1] Noridian Condition Codes — https://med.noridianmedicare.com/web/jea/topics/claim-submission/condition-codes

[2] MassHealth UB-04 Guide — https://www.mass.gov/doc/ub-04-billing-guide-0/download