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CMS 1450 (UB-04) - Overview
The document provides an overview of the UB-04 form which replaced the UB-92 form and was mandated for use in May 2007, it describes the various form locators that make up the UB-04 including those for patient information, billing information, diagnosis codes, and provider information. The presentation aims to educate Medicare Part A providers on properly completing the UB-04 form.
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Introduction to the UB-04 and its mandate as the new standard for institutional billing.
Uniform bill specifics: it replaces UB-92 as of May 23, 2007 for institutional providers.
Refers to key locators required for capturing patient information: provider info, name, address, DOB, and gender.
Details of patient admission including admission date, type, and source of admission codes.
Contains discharge hour, status codes, and examples like discharged to home, other facilities, and expired.
Condition codes for billing scenarios and occurrence span codes detailing patient conditions/events.
Information about responsible parties for payment and various value codes related to billing.
Contains revenue codes and details for services, including total charges and non-covered charges.
Payer information, health plan IDs, payment statuses, and insured’s details related to the patient.
Diagnosis coding specifics, including principal diagnoses, procedure codes, and payment indicators.
Identifies healthcare provider details, types, and taxonomy codes required for claims.