UB04 Condition Codes Code A9: Second Opinion Surgery

Overview

Condition code A9, meaning "Second Opinion Surgery," is not listed in the provided Noridian Condition Codes source, which covers codes 01 through 77. The MassHealth UB-04 Billing Guide does not address specific condition codes. Therefore, no source material is available to describe the use or requirements for code A9. The following sections provide general information about UB‑04 condition codes based on the provided sources, but cannot include authoritative details for code A9. If you need specific billing guidance for second‑opinion surgery, please refer to your payer’s manual or contract.

When to Use

The provided sources do not define when condition code A9 should be used. In general, condition codes on the UB‑04 are placed in field 18–28 to indicate special circumstances that affect claim processing, payment, or patient status. For example, Noridian lists codes such as “01: Military service related” and “02: Workers’ compensation.” Without a source listing code A9, no specific usage instructions can be given.

Step-by-Step Claim Example

No example can be constructed for code A9 because the provided sources do not contain any instructions or examples for this code. For condition codes that are present in the Noridian list (e.g., code 01 for military service), a provider would enter the two‑digit code in field 18 of the UB‑04 and follow applicable payer guidelines. The same general process would apply to code A9 if it were part of the payer’s accepted code set.

Common Mistakes & Audit Red Flags

Since code A9 is not documented in the provided sources, no specific mistakes or red flags can be identified. However, common errors with condition codes in general include entering an invalid code, using a code that does not match the patient’s situation, and failing to place the code in the correct field (18–28). Auditors may flag claims that use a condition code not supported by documentation or a payer’s published list. Providers should always verify that any code they use, including A9, is current and accepted by the payer.

Related Codes/Fields

The following table lists condition codes from the Noridian source that are documented. Code A9 is not present in that source and is shown for reference only based on the user‑supplied meaning.

Code	Meaning	Source
A9	Second Opinion Surgery	User‑supplied (not in provided sources)
01	Military service related	[1]
02	Workers’ compensation	[1]
03	Patient covered by insurance not reflected here	[1]
…	(See Noridian list for codes 04–77)	[1]

All condition codes are entered in UB‑04 fields 18–28. Up to eight codes can be reported in each field. The MassHealth guide does not provide a condition code list; providers must follow the payer’s specific instructions.

---

References

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