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Prepare to transition to the new UB-04 billing form

Managed Care Weekly Advisor, February 21, 2007

Prepare to transition to the new UB-04 billing form

After 14 years, the National Uniform Billing Committee has given form UB-92 a makeover and introduced the UB-04 billing form, which will go live next month. Beginning on May 23, 2007, all providers must submit institutional paper claims using the UB-04. After that date, providers must use the UB-04 form for all paper claims, including adjustment claims. Here are the major changes:

  • The expansion of the diagnosis fields. Now there's one principle diagnosis field, followed by 17 additional fields. This provides the hospital with more chances to report secondary diagnoses.
  • Additional fields to indicate why the patient visited the hospital. This helps to explain to all payers the reasons why you provide the services that you do.
  • An indicator with each diagnosis to specify whether the condition was present on admission.
Apprising staff of the new fields and ensuring that your claims system is ready for the UB-04 is paramount.