This presentation given by PYA Principal Kathy Reep at the 2019 Allied Hospital Associations’ (A2HA) Accounting & Financial Specialist Fall 2019 Meeting will: - Provide an overview of the history of the National Uniform Billing Committee (NUBC). - Cover current issues under review or recently approved. - Stress the importance of associations and other organizations monitoring the activities of the NUBC

1. Kathy Reep, Senior Manager
Business Development
September 24, 2019
NUBC: Overview and Recent Issues

2. A2HA Fall Program 2019 Page 1
NUBC: History
 Established in 1975
 Joint effort of AHA and HFMA
 Do you remember the UB-82?
 First national uniform bill
 13 form designs were previously developed and discarded
 Another version (14th) was tested in Georgia and later
Wyoming
 CMS (HCFA) agreed to five-state pilot test of the UB-16
 Compared with UBF-1 in New York
 Final UB-82 adopted in May 1982
 Established eight-year moratorium on changes to the
structure of the uniform bill (UB)

3. A2HA Fall Program 2019 Page 2
NUBC: Data Specifications
 Need to balance the need for information with the
burden of providing it
 Focus on administrative simplification (HIPAA)
 Goal is to eliminate the need for attachments
 Data specifications manual applies to multiple payers
 Medicare
 Medicaid
 Tricare
 Blue Cross and other commercial insurance claims

4. A2HA Fall Program 2019 Page 3
NUBC: New Formats Developed
 UB-82 followed by UB-92
 Today’s version is the UB-04
 While vast majority of claims are submitted electronically, UB-04
design format is the institutional claim standard
 Electronic format developed around the standard
 Claim no longer just a billing tool
 Now used to identify public health needs

5. A2HA Fall Program 2019 Page 4
NUBC: Voting Members
 Providers
 Chair and secretary from AHA
 Three state hospital associations – either association staff or
member hospital representative
 American Health Care Association
 Two representatives from Federation of American Hospitals
 One representing hospitals, the other long-term care
providers
 National Association for Homecare and Hospice

6. A2HA Fall Program 2019 Page 5
NUBC: Voting Members
 Payers
 Alliance for Managed Care
 America’s Health Insurance Plans
 Blue Cross Blue Shield Association
 Defense Health Agency
 CMS – Medicare
 CMS – Medicaid
 National Association of State Medicaid Directors
 Commercial health plan representative

7. A2HA Fall Program 2019 Page 6
NUBC: Voting Members
 Others
 National Center for Health Statistics
 National Association of Health Data Organizations
 Healthcare Financial Management Association
 Health Information Technology vendor
 ANSI ASC X1 Insurance Subcommittee
 National Uniform Claim Committee

8. A2HA Fall Program 2019 Page 7
NUBC: Process
 Two meetings annually, noticed and open to the public
 Held in conjunction with NUCC
 Change requests must be submitted in writing in format
developed by NUBC
 Must include:
 Field location or data element impacted
 Why the change is needed
 Implication of the change in terms of cost and/or legislative
compliance
 Demonstration that this is a national issue
 Why existing codes are insufficient

9. A2HA Fall Program 2019 Page 8
NUBC: Recent Issues
 Cellular Therapy – CAR-T Billing Methodology
 Appropriate Use Criteria
 Site of Service Address Matching
 Expansion of Number of Authorization Numbers
 Definition of Implant
 Revenue Code 017x – Nursery Levels

10. A2HA Fall Program 2019 Page 9
NUBC: Meetings for 2020
 April 7-8, 2020
 Baltimore
 August 11-12, 2020
 Chicago
 Importance of state association participation
 Subscription to national manual

11. PYA, P.C.
800.270.9629 | www.pyapc.com
Questions:
Kathy Reep
kreep@pyapc.com