What is a revenue code on a ub04?
Revenue codes are three-digit codes that affect reimbursement and represent the services provided by the ASC facility for a payer. Note that you can’t report revenue codes on a CMS-1500 form, but you can report them on a UB-04.
How many boxes does UB-04 have?
There are 81 fields or lines on a UB-04. They’re referred to as form locators or “FL.” Each form locator has a unique purpose: Form locator 1: Billing provider name, street address, city, state, zip, telephone, fax, and country code.
What is Box 70 on ub04?
But that should not be set as a default. Box 69 is the diagnosis used to indicate the reason for the admission, while 70 is used to indicate, for an unscheduled outpatient visit, what the patient indicated as their reason for visit to the provider.
What does the UB in ub04 represent?
In medical billing, the term UB stands for Uniform Billing. As the name Uniform Billings suggests, UB simply refers to the process of making medical billing both uniform and streamlined for reimbursement purposes.
What are the revenue codes?
Revenue codes are 4-digit numbers that are used on hospital bills to tell the insurance companies either where the patient was when they received treatment, or what type of item a patient might have received as a patient. A medical claim will not be paid if this is missing from a bill.
What is Box 53 on ub04?
Form Locator 53: Assignment of benefits (a) Primary, (b) Secondary, and (c) Tertiary. Form Locator 54: Prior payments (a) Primary, (b) Secondary, and (c) Tertiary.
What is Box 59 on a ub04?
59. Patient’s Relation to Insured Enter the code for the patient’s relationship to the insured. Insured’s Unique Identifier Enter recipient’s nine-digit Medical Assistance ID. This id must be entered in line A,B,C that corresponds to the line in which the RI Medicaid payer information is entered in locator 50.
What is Box 38 on a ub04?
38 Responsible Party Name and Address Required This field is for reporting the name and address of the person responsible for the bill. 39 – 41 Value Codes and Amounts Conditional These fields contain the codes and related dollar amounts to identify the monetary data for processing claims.
What is Box 53 on UB04?
What is type of bill in UB04?
Type of bill codes are four-digit alphanumeric codes that specify different pieces of information on claim form UB-04 or form CMS-1450 and is reported in box 4 on line 1.
How to complete ub04 for facility institutional providers?
filling in each field on the UB-04 claim form is required, not required, required when applicable, or optional when completing a Medica claim. An asterisk next to a field indicates that further information is necessary to complete the field (e.g., bill type, revenue code lists and descriptions, patient disposition codes). This additional
What is the UB-04 claim form used for?
The UB-04 is a claim form that is utilized for Hospital Services and select residential services. Please note that these instructions are specifically written to correlate with Partners Behavioral Health Management’s Claim Management System – Alpha MCS.
What is box 14 in partners health management?
Box 14 – Admission Type (priority) of Visit: (Required) This field requires a one digit code that indicates the priority of the admission.