2010 UBO/UBU Conference

Title: Basic UBO Billing – the UB-04

Session: T-1-1100

Objectives for This Session

Understand the UB-04 Institutional Claim Form Understand the data elements Why are they necessary for claim submission? Where does the data flow from?

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The Critical Role of Coding UB-04 – DRGs

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Medicare Severity Adjustment DRGs FY 2008 IPPS Final Rule - August 1, 2007

Effective October 1, 2007

Major Complications and Comorbidities – MCCComplications and Comorbidities – CCNon Complications and Comorbidities – Non CC

Medicare Severity Adjustment DRGs FY 2008 IPPS Final Rule - August 1, 2007

Effective October 1, 2007

Major Complications and Comorbidities – MCCComplications and Comorbidities – CCNon Complications and Comorbidities – Non CC

UB-04 Claim Form

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Field Locators

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Field Locators for the UB-04

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POA Indicator

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A code indicating whether or not the condition was present on admission or was clearly present, but not diagnosed, until after

the admission took place

• Report with Principal and Secondary Dx•Applies to inpatient records only•Not required for FL 72 E-codes

A code indicating whether or not the condition was present on admission or was clearly present, but not diagnosed, until after

the admission took place

• Report with Principal and Secondary Dx•Applies to inpatient records only•Not required for FL 72 E-codes

Field Locators – UB-04

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Medicare Severity Adjustment DRGs FY 2008 IPPS Final Rule - August 1, 2007

Effective October 1, 2007

Major Complications and Comorbidities – MCCComplications and Comorbidities – CCNon Complications and Comorbidities – Non CC

Medicare Severity Adjustment DRGs FY 2008 IPPS Final Rule - August 1, 2007

Effective October 1, 2007

Major Complications and Comorbidities – MCCComplications and Comorbidities – CCNon Complications and Comorbidities – Non CC

Summary

1. We have gone through the data elements necessary for Submitting an Institutional Claim form

2. We have gone through individual data elements required for billing

3. We have discussed why information is necessary

4. We understand now where the data flows from

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Questions

Thank you for attending this session Any questions??

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