What are value codes on UB04?

What are value codes on UB04?

Value Codes

Code Description Addtional Description
81 Non-Covered Days Effective 03/01/07 Hardcopy UB04 Claims
82 Coinsurance Days Effective 03/01/07 Hardcopy UB04 Claims
83 Lifetime Reserve Days Effective 03/01/07 Hardcopy UB04 Claims
84-99 Reserved for National Assignment

What is value code 01 on a UB04?

The value codes to be submitted when billing private room revenue codes according to the UB-04 Specifications Manual are: “01” (semi-private room facility) must be accompanied by the semi-private room rate when facility offers semi-private rooms and the patient’s stay is in a private room.

What can be billed on a UB-04?

Who Can Bill Claims Using the UB-04?

  • Community mental health centers.
  • Comprehensive outpatient rehabilitation facilities.
  • Critical access hospitals.
  • End-stage renal disease facilities.
  • Federally qualified health centers.
  • Histocompatibility laboratories.
  • Home health agencies.
  • Hospices.

What is UB-04 Box 17?

17. * Patient Status Enter the 2-digit patient status code that best describes the patient’s discharge status. 05-Discharged/transferred to another type of institution for inpatient care or referred for outpatient services to another institution.

What is Box 53 on UB04?

Form Locator 52: Release of information (a) Primary, (b) Secondary, and (c) Tertiary. Form Locator 53: Assignment of benefits (a) Primary, (b) Secondary, and (c) Tertiary. Form Locator 54: Prior payments (a) Primary, (b) Secondary, and (c) Tertiary.

What is Box 59 on a UB04?

Insured’s Name If other health insurance is involved, enter the insured’s name. 59. Patient’s Relation to Insured Enter the code for the patient’s relationship to the insured.

What indicates the frequency of care on a UB-04 claim form?

A four-digit code; the first digit is a leading zero, the second digit identifies the type of facility where services were rendered, the third digit classifies the type of care being billed, and the fourth digit, a “frequency” code, indicates the sequence of the bill within a given episode of care.

What should a provider do when reporting more than four modifiers on the CMS 1500 claim?

NOTE: The Form CMS 1500 currently has space for providing four modifiers in block 24D, but, if the provider has more than four to report, he/she can do so by placing the -99 modifier (which indicates multiple modifiers) in block 24D and placing the additional modifiers in block 19.

What is value code 50 on UB04?

Background: This instruction removes the requirement for providers to report the total number of therapy visits using value code 50 – physical therapy, 51 – occupational therapy, 52 – speech therapy, and 53 – cardiac rehab.

What are claim value codes?

The code indicating a monetary condition which was used by the intermediary to process an institutional claim. The associated monetary value is in the claim value amount field (CLM_VAL_AMT).

What is value code 80 on UB04?

The number of covered days (value code 80) must match the number of units and charges reported for the covered room and board days. Claims to be paid by Per Diem reimbursement should have the appropriate covered days reported to match the authorization.

What is a value code on a claim?