2010 ubo/ubu conference title: basic ubo billing – the ub-04 session: t-1-1100
TRANSCRIPT
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
3
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
4
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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