2011 nubc manual discharge codes

Dec 11, 2019 apr 1, 2004 national uniform billing committee nubc and to add all nubc additionally, all codes that have been approved by the nubc and that se1117 cms. For status codes, please refer to the nubc ub04 manual. These codes are subject to change, and the department of defense will no longer allow the military services to release the meanings of these codes to the general public. System chars discharge data to the department of health doh. Jul 6, 2015 implementation of new national uniform billing committee nubc code 53 initial placement of a medical device provided as part of a cms manual system.

West virginia hospital inpatient data system data element specifications guide february 7, 2011 page 3. It is a refresher from the provider billing manual. The following changes have been made by the national uniform billing committee nubc and are outlined below. Up to 22 revenue codes and associated charges may be entered on each ub04 claim form. If your last plotted visit is an 11, contact the office and ask that it be changed to an 18 or 19. The codes should be listed alphanumerically from left to right, beginning with fl31a. Patient nameidentifier required the patient is the person who received services. The hospice does not report occurrence code 42 on their claim. Report this code when the patient is dischargedtransferred to. Discharge status codes approved effective october 1, 20.

In 2011 12 chars transitioned to the 837 5010 file format and october 1, 2014 with the united states will move to icd10 codes. This fourdigit alphanumeric code gives three specific pieces of cms manual system cms. The national uniform billing committee nubc makes their ub04 manual available through their website. New york state ub04 billing guidelines version 2011 01 61 2011. Uniform billing committee nubc at its february 2005 meeting. Aarp health insurance plans pdf download medicare replacement pdf download medicare benefits pdf download.

Complete list of military separation codes on documents. This manual, ed by the american hospital association, is the only. Nubc meeting march 12, 2011 hilton garden inn chicago mar 1, 2011 line item dates on inpatient claims nubc and dsmo crs 1. Most of your questions relate to the two most frequent discharge service codes you use, which are for patients whove been admitted. To view a sample alp ub04 claim form, see appendix a. Fl16 discharge hour fl17 patient discharge status fl18 condition code fl19 condition code. The discharging facility should ensure that documentation in the patients medical record supports the billed discharge status code. In 201112 chars transitioned to the 837 5010 file format. National uniform billing committee nubc update to chapter 25. Providers using the cd will need to retain all bulletins received throughout the year to use in addition to the cd. Some fields have been have been changed or codes have been added or deleted for existing fields. Admission type code 9 and admission source code 9 are not allowed. This section contains medicare requirements for use of codes maintained by the nubc that are.

Locator 17 patient discharge status 01 discharged 30 still patient locator 38 responsible. If discharging on your final scheduled visit, as initially plotted at soceval, make sure that the service code is a 19 for discipline only, or 18 for agency dc oasis. The values for discharge status are taken from the national uniform billing committee nubc manual which is used by the billinghim to complete the ub04. The nubc official data specifications manual lists these codes and their detailed descriptions. Many types of providers use the ub04 claim form to. Hospital discharge discharges for charity or free standard codes and submit them to the tdh hdds staff. These are 99238, hospital discharge day management 30 minutes or less, and 99239, hospital discharge day management more than 30 minutes. New patient discharge status codes type of bills tob 32x and 34x. The effective date on or after the date of service for outpatient claims and on or after the date of discharge for inpatient claims. Billing committees nubc official ub04 data specifications manual. The provider enters the code indicating the source of the referral. In the case of a discharge for cause, the hospice uses the nubc approved discharge status code that best describes the beneficiarys situation. June 2011 snf outpatient page 1 of 3 skilled nursing facility snf part b outpatient claims locator 1 billing provider name, address, and telephone number minimum requirement is the providers name, city, state, and 9digit zip code.

Manual developed by the national uniform billing committee nubc. Patient discharge status code reporting a discharge occurs when a medicare beneficiary leaves an acute care hospital after receiving acute care treatment. Cl1 02 previously called the source of admission change this is only required for ip. Nubc occurrence code s february 20, 2020 admin no comments. Apr 28, 2011 search for the rhc billing manual for revenue code 0900 from both rhcs. The national uniform billing committee nubc created a new patient discharge. Official ub04 data specifications manual 2020 page 20. All inpatient discharges including psychiatric andor behavioral health, rehabilitation. Ub04 claim form this document explains the ub04 claim form, which is used for submitting claims for reimbursement for specially designated facilities. New patient discharge status code 21 to define discharges billing committee nubc created a new patient discharge code to.

The chars procedure manual and chars companion guide supplement the national uniform billing committee uniform billing form 2004 nubc ub04 and the asc x12. The purpose of the tob chart in the manual to help guide hipaa users nubc billing alert national uniform billing committee nov 17, 2010 billing alert. Point of origin and discharge status codes for designated disaster alternate care. Nicu level of care criteria blue shield of california. Origin for admission or visit codes to the ub04 cms1450 manual code list. Fl 16 discharge hour 48 fl 17 patient discharge status 49 fl 1828 condition codes 65 fl 29 accident state 81 fl 30 reserved for assignment by the nubc 82 fl 34 occurrence codes and dates 83 fl 3536 occurrence span codes and dates 92 fl 37 reserved for assignment by the nubc 96. As the health care industry prepared for hipaa implementation, it. This manual contains the updated specifications for the data elements and codes included on the cms1450 and used. The data elements and codes are developed and maintained by the national uniform billing committee nubc. Homecare homebase discharge procedures a planned discharge. The national uniform billing committee nubc created a new patient discharge code to define discharges or transfers to courtlaw enforcement. National uniform billing committee, american hospital association.

Dataelem0247 manual performance measurement network. Patient discharge status codes are part of the official ub04 data specifications manual and are used nationwide by institutional, private, and public providers, and payers of health care claims. May 1, 2017 current edition of the nubc manual for a list and descriptions of valid discharge the date of denial in the occurrence code fields 34 ab. Refer to the national uniform claim committee nubc instruction manual available at. Instructions, ub04 dialysis ohio department of medicaid. Aarp health insurance plans pdf download medicare replacement pdf download aarp medicarerx plans united healthcare pdf download medicare benefits pdf download. The ub04 is the replacement for the ub92 form and represents the culmination of a fouryear study that involved numerous public surveys and discussions at various nubc meetings. Description fl01 billing provider name fl01 billing provider street address.

Hmsa has determined that it will use the national uniform billing committee nubc official ub04 data specifications manual as the standard source for codes and code descriptions to be entered in the various form locators fl. Because this data element is critical in determining the population for many measures, the abstractor should not assume that the ub04 value is what is reflected in the medical record. Emedny information inpatient hospital version 2011 01 61 2011. The discharge status code identifies where the patient is being discharged to at the end of their facility stay or transferred to such as an acutepostacute facility. R2250cp 07012011 nonsystems internet only manual iom. The code usage includes transfers to incarceration facilities such as jail, prison or other detention facilities. You can access the ub04 billing information adopted by the nubc by subscribing to the official ub04 data specifications manual. This includes claims with a frequency code of 1 admit through discharge. A patient discharge status code is a twodigit code that identifies where the patient is at the conclusion of a health care facility encounter or at the end of. Hospital discharge data system user manual august 2018 7 numerous and significant changes have been made to the ub04 manual from 2011 through 2018. Tips for completing the ub04 cms1450 claim form revised 04. Sep 18, 2014 ub04 discharge status codes a patient discharge status code is a twodigit code entered into form locator fl 17 on the ub04 claim form that identifies the patients status at the conclusion of a health care facility encounter this could be a visit or an actual inpatient stay or at the time end of a billing cycle the through date of a.

Poa that was developed to assist the national uniform billing committee nubc in its deliberations on whether to add poa to the ub. To view and utilize the link and search functions of the manual, you will need to have. This code indicates the patients discharge status as of the. Billing highlights skilled nursing facility part b outpatient. Locator 16 discharge hour required on inpatient claims with a frequency code of 1 or 4 last digit of bill type. Patient address required the patient address will be the facility address.

Ub 04 medicare discharge status code cms 1500 claim form. Instructions for completing the ub04 claim form the ub04 claim form is used to submit claims for inpatient and outpatient services by institutional facilities for example, outpatient departments, rural health clinics, chronic dialysis and adult day health care. Nubc occurrence codes february 20, 2020 admin no comments. Changes to the manual from 2011 through 2017 numerous and significant changes have been made to the ub04 manual from 2011 through 2017. Military separation codes are contained in your military records and may be annotated on various military separation documents. Chars follows nubc standards except for state specific requirements. Masshealth billing guide for the ub04 executive office of. A ub04 with field descriptions and instructions is included in the link below. Locator 15 point of origin for admission or visit previously known as source of admission.

Enter the discharge hour as described in the ub04 manual. Again, care must be taken to make sure that these codes are as accurate and detailed as they can possibly be. Committee nubc payer only codes to the medicare claims processing manual, chapter 1 value. The chars system is currently authorized under revised code of washington rcw. Select the appropriate code from the nubc ub04 manual. However, in some cases, hmsa varies from nubc directions concerning whether a specific field is required or how the. Alp providers who choose to submit their claims on paper forms must use the national uniform billing committee nubc ub04 claim form. Jan 05, 2015 nubc meeting march 12, 2011 hilton garden inn chicago mar 1, 2011 line item dates on inpatient claims nubc and dsmo crs 1. June 2011 snf outpatient page 1 of 3 skilled nursing facility snf part b outpatient claims locator 1 billing provider name, address, and telephone number. Most common payer idhealth plan id numbers naic codes. The national uniform billing committee nubc has approved the.

The national uniform billing committee nubc is responsible for the design. Locator 3 patient control number the unique patient account number assigned by the provider. Point of originvisit previously source of admission codes 2011. Download a sample of the form by visiting the cms forms list web page. The purpose of the hospital discharge data system hdds is to collect and summarize hospital. Billing highlights skilled nursing facility part b. Nubc voted to accept the ub82 and its associated data manual for implementation as a. See nubc official ub04 manual for additional codes. Apr 1, 2004 national uniform billing committee nubc and to add all nubc additionally, all codes that have been approved by the nubc and that se1117 cms. The purpose of the tob chart in the manual to help guide hipaa users nubc billing alert national uniform billing committee nov 17, 2010. Chars procedure manual washington state department of.

The following fields have been updated to match the fields in the nubc manual. When the discharge date is different than the statement through date, the discharge date is reported using. The emedny system allows new york medicaid providers to submit claims and receive payments for medicaidcovered services provided to eligible members. The instructions included in this section are excerpts from medicare instructions rev. Instead, the hospice reports condition code h2 to indicate a discharge for cause. In addition to 99238 and 99239, you can bill two other discharge codes. Some fields have been changed, or codes have been added or deleted for existing fields. This manual, ed by the american hospital association, is the only official source of ub data. For discharge dates after and including august 2, 2011, the value of 7 will fail. National uniform billing committee nubc maintains the type of bill code set.

Nov 2, 2007 status code 70 and a definition change to existing patient discharge meeting nubc has redefined the patient discharge status code 05 to. Medicare 75 general instructions for completion of form cms1450 for billing. No other publication governmental or privatecommercial can be considered authoritative. The data elements and codes are developed and maintained by the national uniform billing committee. Ub04 discharge status codes a patient discharge status code is a twodigit code entered into form locator fl 17 on the ub04 claim form that identifies the patients status at the conclusion of a health care facility encounter this could be a visit or an actual inpatient stay or at the time end of a billing cycle the through date of a. The manual was created in adobe acrobat portable document format pdf. Jan 07, 2016 patient discharge status codes are part of the official ub04 data specifications manual and are used nationwide by institutional, private, and public providers, and payers of health care claims. Complete this field if an admission or a discharge other than to home or self care occurred during the. Highmark blue shield billing highlights june 2011 snf outpatient page 3 of 3. The national uniform billing committee nubc ballots and maintains these condition codes as part of the nubc universal billing ub code set, which is an external code set requests for new codes or modification of codes may be submitted through the nubc web site at. Ub04 data specifications manual and the centers for medicare and medicaid services cms international classification of diseases, ninth revision, clinical modification icd9cm official guidelines for coding and reporting. Enter the appropriate twocharacter condition codes. National uniform billing committee nubc update to chapter 25 effective date. The ub04 manual also contains a section established for state guidelines.