What is Box 17 on a UB04?
What is Box 17 on a UB04?
17. * Patient Status Enter the 2-digit patient status code that best describes the patient’s discharge status. 05-Discharged/transferred to another type of institution for inpatient care or referred for outpatient services to another institution.
What are value codes on UB04?
Value Codes
| Code | Description | Addtional Description |
|---|---|---|
| 81 | Non-Covered Days | Effective 03/01/07 Hardcopy UB04 Claims |
| 82 | Coinsurance Days | Effective 03/01/07 Hardcopy UB04 Claims |
| 83 | Lifetime Reserve Days | Effective 03/01/07 Hardcopy UB04 Claims |
| 84-99 | Reserved for National Assignment |
What box number is place of service on UB04?
There is no POS code on a UB-04 form – the place of service is derived from the bill type and other information on the claim.
What goes in box 81cc on a UB04?
81. CC Code-Code Field Enter the taxonomy qualifier and corresponding 10-digit Provider Taxonomy Code for the NPI number reported in field 56.
What are UB condition codes?
Condition codes refer to specific form locators in the UB-04 form that demand to describe the conditions applicable to the billing period. It is important to note that condition codes are situational. These codes should be entered in an alphanumeric sequence.
What is Box 76 on UB04?
Attending Provider Names and Identifiers
76 Attending Provider Names and Identifiers Required This field is for reporting the name and identifier of the provider with the responsibility for the care provided on the claim.
What is the value code on a claim?
The code indicating a monetary condition which was used by the intermediary to process an institutional claim. The associated monetary value is in the claim value amount field (CLM_VAL_AMT).
What does A3 value code mean?
Estimated Responsibility Payer
A3. Estimated Responsibility Payer A. Amount the provider estimates will be paid by the indicated payer.
What is Box 14 on a UB04?
Box 14 – Admission Type (priority) of Visit: (Required) This field requires a one digit code that indicates the priority of the admission.
What is Box 76 on ub04?
What is loop 2310b on UB-04?
This usually occurs when you have your type 1 (individual) NPI entered under Admin in Therabill (as the billing provider) and you are submitting it as an organizational NPI. If the payor that you are submitting to is expecting a group NPI, you will receive this error.
What is Box 74 on UB04?
principal procedure code and date
Guest. Box 74 is for the principal procedure code and date. It is required on inpatient claims where a procedure is performed. It is not used on outpatient claims.
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 the value code?
What does value code B2 mean?
Coinsurance Payer
B2. Coinsurance Payer B. The amount the provider assumes will be applied toward the patient’s coinsurance amount involving the indicated payer. For Part A coinsurance amounts use Value Codes 8-11.
What is Box 42 on ub04?
Box 42 – Revenue Code: (Required) For General Hospitals, please use the appropriate revenue code(s) in a 4 digit format with a leading zero.
What loop and segment is Box 17?
CMS-1500 Claim Form Crosswalk to EMC Loops and Segments
| CMS-1500 Form Item | CMS-1500 |
|---|---|
| 16 | Dates Patient is Unable to Work in Current Occupation |
| 17 | Name of Referring/Ordering Provider |
| 17 | Qualifier DN = Referring Provider DK = Ordering Provider DQ = Supervising Provider |
| 17A | Other ID# |
What does loop 2310B missing mean?
Why is this happening? This usually occurs when you have your type 1 (individual) NPI entered under Admin in Therabill (as the billing provider) and you are submitting it as an organizational NPI. If the payor that you are submitting to is expecting a group NPI, you will receive this error.
