Overview
The standard, uniform bill (UB) for institutional healthcare providers that is used throughout the United States is known as the UB-92 and was adopted by CMS as the CMS 1450. At it's February 2006 meeting following a four-year study, the National Uniform Billing Committee (NUBC) adopted the UB-04 to replace the UB-92. Hospitals, nursing homes, hospice, home health agencies, and other institutional providers use the UB.
The primary purpose of the UB-04 is to align the paper form to the ANSI 837i electronic data standards, both the current 004010/004010A1 and the future 005010. In addition, it allows for the use of the National Provider Identifier (NPI) mandated May 22, 2007. The UB-04 also freed up "real estate" on the UB-92 paper form, providing space for alternative reporting data.
The UB-04 paper format may be used March 1, 2007 and is mandated effective May 23, 2007. The UB-92 paper claim will not be accepted, even as an adjustment claim, after May 22, 2007.
Order your copy of the UB-04 Manual
UB-04 Form
UB-04 to UB-92 Crosswalk
Present on Admission
Section 5001( c) of the Deficit Reduction Act of 2005 requires hospitals to begin reporting the secondary diagnoses that are present on admission (POA) of patients effective for discharges on or after October 1, 2007.
Guidelines for POA
MLN Matter POA
Additional Resources:
National Uniform Billing Committee (NUBC) http://www.nubc.org
NUBC UB-04 Information http://www.nubc.org/INFORMATION_ON_UB-04.pdf
If you have any questions, contact Gilbert Johnson, Vice President of Health Information Systems at (605) 361-2281 or click here.
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