Author Topic: Question on the UB 04  (Read 1993 times)

psmb702

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Question on the UB 04
« on: October 31, 2010, 01:45:47 AM »
Hi everyone!
I do the billing for an ambulatory surgery center and am filling out my first UB04 form. I purchased the book "How to complete a UB04 form" from Scott and Redmond - but still have a couple of questions.

1) In box 39 - Im using code 15 (its a WC case) but don't know how to get the amount. What amount are they asking?
2) Box 42 - I'm confused on the rev code descriptions/categories. Is the room and board mean that the patient stayed overnight? And what does private (deluxe) mean? Does 'operating room services' mean in the hospital?
I see ambulatory surgical as a category - however the descriptions are 'general' and 'other ambulatory surgical care'. What is the difference?

I am billing for a patient that had surgery on the knee. She was released back to home and did not stay over night.

If anyone could be of assistance - that would be great~ thank you!

psmb702

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Re: Question on the UB 04
« Reply #1 on: October 31, 2010, 02:13:32 AM »
Sorry - a few more questions were raised --

Box 72 (external injury code) - I believe I need to fill in the box as it is work comp - however I don't see where I can find the injury codes.
Box 76 - what is the difference between OB (st lic number) and G2 (Provider Commercial Number)?
Can the attending and operating Dr be the same?
Box 77 - If I put the providers EIN in - its the EIN of the group that the claim will pay to, right?

Are taxonomy codes now required on the UB04?

THANK YOU IN ADVANCE

Michele

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Re: Question on the UB 04
« Reply #2 on: November 02, 2010, 07:09:08 AM »
1) In box 39 - Im using code 15 (its a WC case) but don't know how to get the amount. What amount are they asking?  I have not done a value code for WC, but I would put the enter amount of the claim.


2) Box 42 - I'm confused on the rev code descriptions/categories. Is the room and board mean that the patient stayed overnight? And what does private (deluxe) mean? Does 'operating room services' mean in the hospital?

For what you are describing you wouldn't be billing for room & board, that is for overnight stays.  You would be using operating room services.  It doesn't have to be a hospital, it just has to be classified as an operating room.  Since you are an ambulatory surgery center, that would be accurate. 


Box 72 (external injury code) - I believe I need to fill in the box as it is work comp - however I don't see where I can find the injury codes.    These would be the E codes in the ICD9 codes.  They are in any ICD9 book, or on the online ICD9 lookups.  One website is http://www.icd9coding1.com/flashcode/home.jsp


Box 76 - what is the difference between OB (st lic number) and G2 (Provider Commercial Number)?  Some carriers still issue unique provider numbers, even though with the start of NPI they are not supposed to require them.  That would be the G2.

Can the attending and operating Dr be the same?    Yes


Box 77 - If I put the providers EIN in - its the EIN of the group that the claim will pay to, right?   Yes



Are taxonomy codes now required on the UB04?  - I am not aware of anyone requiring taxonomy codes on the UB04 yet.  I know it will be coming!
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