Medical Billing Forum

General Category => General Questions => Topic started by: pfazik on November 12, 2008, 12:56:33 PM

Title: Completing box 56 and 57
Post by: pfazik on November 12, 2008, 12:56:33 PM
I am looking for guidance with the UB-04.  If the patient is seen in the ED but leaves after being seen by a triage nurse only, what is placed in Box 56 of the UB-04?  I only perform professional billing but I am being asked this question and I am not clear.  Thanks for any help. 

Pam
Title: Re: Completing box 56 and 57
Post by: Michele on November 14, 2008, 01:22:18 PM
Box 56 is for the NPI number.  You would still enter this field with the NPI number of the entity that should be paid.  I'm assuming hospital's NPI since you are billing for the emergency department charges.

Thanks
Michele
Title: Re: Completing box 56 and 57
Post by: pfazik on November 14, 2008, 01:35:28 PM
 That is my understanding but other staff is stating that it has to be a "provider".  This makes no sense since the nurses who provided a triage only do not have an NPI.  Thanks for your assistance Michele.

Pam
Title: Re: Completing box 56 and 57
Post by: Michele on November 14, 2008, 09:05:10 PM
It is not the rendering provider NPI that goes in box 56.  It is the billing entity NPI.  The attending provider would be where the rendering provider NPI goes.  Even if the patient leaves after Triage, the er dr that is on staff is supervising the triage nurse so their individual NPI would go in the attending dr's npi field.

Hope that helps (it looks confusing when I read it back!) :(

Michele