Medical Billing Forum

Billing => Facility Billing => Topic started by: jeannie on September 16, 2008, 11:01:57 AM

Title: type of bill and value codes
Post by: jeannie on September 16, 2008, 11:01:57 AM
I am going to begin billing for a substance abuse treatment center. I am only billing for the room and board portion on UB04s. I have figured out the revenue codes and the type of service code but I cannot find any documentation on what the type of bill would be and what value codes are required. We have private and semi-private rooms only. We do not do any detoxification. Thanks! :)

Jeannie
Title: Re: type of bill and value codes
Post by: Michele on September 16, 2008, 08:50:40 PM
Hi Jeannie,

   Different insurance carriers may require different type of bill codes, but it looks like you would need either 861 or 891.  861 is for residential facility admit thru discharge, and 891 is for special facility other, admit thru discharge.

Michele
Title: Re: type of bill and value codes
Post by: jeannie on September 16, 2008, 10:00:46 PM
What about value codes? I am new to UB04 billing and have your book. I just want to make sure my first claim goes out correctly!
Title: Re: type of bill and value codes
Post by: Michele on September 17, 2008, 09:25:57 PM
The value codes are only used if there are any applicable.  Look thru the list in our book and see if there are any that apply.  We don't use any value codes when billing for outpatient drug & alcohol rehab, but you should look the list over for the room & board.  I personally don't see any that seem to be appropriate for what you have described so I would leave the value codes blank.

Don't worry, you'll get it figured out.  It's always hard the first time you do something. 

Good luck

Michele
Title: Re: type of bill and value codes
Post by: deniserobinson on December 11, 2008, 07:20:46 AM
Hi am also new to the uB04 i am in North Carolina.  They have changed our Type of service from 893 86x i don know what the third number is.  This is the first time i am billing for a level III residental services. Code H0019 I also need to know the Rev Code. I keep getting denied this is the fifth time i am entering the information. Please help
Title: Re: type of bill and value codes
Post by: Michele on December 11, 2008, 07:40:30 PM
The last digit defines the frequency of the bill.  3 means interim continuing claim.  The 2nd digit defines the bill classification.  6 means residential facility and 9 means other.  Since they requested you change from 893 to 86x I would think the 3 for the 3rd digit would still be applicable.  The rev code for H0019 would depend on what the treatment is for.  For example 944 is for drug and 945 is for alcohol.

If you need more assistance we do have an ebook on completing the UB04 that contains a list of rev codes and a chart for determining type of bill.  You can find it at:

http://www.medicalbillinglive.com/UB04-forms-book.shtml

Good luck
Michele
Title: Re: type of bill and value codes
Post by: athacher on April 08, 2009, 02:47:01 PM
I have a question regarding this as well.  I sent a claim to Horizon BC with a bill type 867 (I have always used the 86- codes when billing with no problem from any other insurance company)  Horizon BC is denying the claim for incorrect bill type stating the "6" means "outpatient".  Have the bill type codes been changed and I'm just out of the loop?

Also we are a licensed RTC, but we are not a participating provider with any insurance carrier.  Can I still use the UB04 or do I need to be using the CMS1500?

 
Title: Re: type of bill and value codes
Post by: Michele on April 09, 2009, 10:18:04 AM
The 6 actually means residential facility.  3 means outpatient.  If you are a facility then you should be billing on the UB04.  The CMS form is for the professional charges, not the treatment facility charges.

Michele
Title: Re: type of bill and value codes
Post by: athacher on April 14, 2009, 01:29:55 PM
Then is Horizon BC the one not playing fair with my codes?  That's just rude... :-\
Title: Re: type of bill and value codes
Post by: Michele on April 14, 2009, 09:50:12 PM
We actually were just told today by BCBS of FL that we need to use type of bill 111 for our inpatient residential drug facility.  We were using 861 which more accurately describes the facility, but they want the 111.  You need to find out what they are looking for and use it (as long as it is not completely wrong).

Michele
Title: Re: type of bill and value codes
Post by: dedwards on May 01, 2009, 01:17:15 PM
Hi Michelle,
I just went to your website and looked at your book explaining competing UB-04 forms.  It looks fantastic and hope it can help me!
Since I am having so many problems understanding just what I need to put in the fields, I would like to order it, but I wanted to ask you a question first. Will it help me in my situation for filing partial hospitalization, Part A Medicare?  I will be billing for a mental health facility.
Thank you very much,
Debbie
Title: Re: type of bill and value codes
Post by: Michele on May 02, 2009, 06:49:17 PM
I'm not sure if it will be helpful or not.  It is not specific for any one line of business.  It is just a detailed description of each field with lists of codes for the fields.

Michele
Title: Re: type of bill
Post by: CMorgan on May 07, 2015, 03:24:07 PM
I am billing for an inpatient residential treatment facility for substance abuse.  I used the 862 code on the UB04 and it was kicked back stating that was not inpatient.  What bill type would I use then?

I know the last digit is the frequency, but how do you know what the first 2 digits are?
Title: Re: type of bill and value codes
Post by: amr_1024 on November 19, 2015, 03:52:53 PM
I see that this thread has been inactive. Im hoping by responding someone will respond. Im have the same issue billing Residential Treatment Claims to Blue Cross, they requested 861 but is now rejecting because of the admission date and the statement from date and discharge status does not match... have there been any updates on this issues since the last post??
Title: Re: type of bill and value codes
Post by: Michele on November 20, 2015, 08:45:45 AM
Are you billing for the entire treatment?  Admit thru Discharge?  If so wouldn't the admission date and the statement from date be the same?