Author Topic: Box 76 & 77 on UB04 - is it for the referring dr?  (Read 1168 times)

Alice Scott

  • Global Moderator
  • Full Member
  • *****
  • Posts: 205
    • Solutions Medical Billing
Box 76 & 77 on UB04 - is it for the referring dr?
« on: April 03, 2008, 01:33:54 PM »
Question
Hi~

I just purchased your ub04 e-book. Thank you.  There is a question that I have.  I am billing for CORF's now and in box 76 and 77, can you tell me if that is the referring physician that goes in those fields.  I have been putting the corf physician in box 76 and the referring in box 77, but I've been told that we can but the referring in box 76 and do not need box 77.  If I do put the referring in box 76 what do I put in the qualifier and the id beside it on 76?
Thanks so much for your help.
What other speciality e-books do you have?
Rhonda M

Answer
Hi Rhonda,

   I’m not familiar with CORF but the description of the boxes doesn’t really describe what you are doing.  The description for 76 states that it is the ordering physician, and box 77 is the operating physician.  However there is not a specific box for referring physician.  Personally, I would have switched them around making the ‘ordering physician’ box 76 as the referring physician, and the CORF physician in box 77 as the operating physician.  But if you have been submitting claims and they’ve been being paid, I hate to mess around with things.  There is also box 78 which can be used to indicate any other physician, so you could enter the referring physician there.    I would recommend contacting one of your insurance carrier’s provider reps and ask them how they want the information entered.  They are usually very helpful and you can put an end to it once and for all.

As far as the qualifier, depending on what insurance you are billing, you need to enter a qualifier for that insurance as well as the matching identifier.  For example, if you are billing Medicare, you would enter a qualifier of IG and then enter the provider’s UPIN number.  (This will probably be obsolete soon, with the increasing use of the NPI)

Thanks

Michele
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com