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Medicare Information Resource

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Medicare Information Resource Part B
MIR-2007- 06A, June 2007

Implementation of the UB-04 Fact Sheet (PE200704-31)

The Centers for Medicare & Medicaid Services (CMS) Learn Resource article 200704-31 was removed from the News list on April 24, 2007 due to a content problem in the UB-04 form crosswalk included with the Fact Sheet. The crosswalk information has been clarified and the UB-04 Fact Sheet has been reposted to the Internet.

The following change was made to the crosswalk information included with the Fact Sheet:

The remark “eliminated 1” next to FLs 42 and 43 on the crosswalk above is in reference to the reduction in the number of revenue codes and revenue code descriptions from 23 on the UB-92 to 22 on the UB-04. 

The Implementation of the UB-04 Fact Sheet is available in downloadable format from the Medicare Learning Network (MLN). This Fact Sheet reviews the new UB-04 paper claim form which is only accepted from institutional providers excluded from the mandatory electronic claims submission. It includes background information, the transition period, and a crosswalk. The following link will take you to the UB-04 Fact Sheet:

http://www.cms.hhs.gov/MLNProducts/downloads/ub04_fact_sheet_050207.pdf External PDF.

Related to CMS Learn Resource PE200704-31

CPT five-digit codes, descriptions, and other data only are copyright 2006 American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in CPT. AMA does not directly or indirectly practice medicine or dispense medical services. AMA assumes no liability for data contained or not contained herein.   Applicable FARS/DFARS clauses apply.

 

   
 
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