Title: Basic UBO Billing – the UB-04 Session: T-1-1100

1. Title: Basic UBO Billing – the UB-04 Session: T-1-1100

2. 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?

3. The Critical Role of Coding UB-04 – DRGs Medicare Severity Adjustment DRGs FY 2008 IPPS Final Rule - August 1, 2007 Effective October 1, 2007 Major Complications and Comorbidities – MCC Complications and Comorbidities – CC Non Complications and Comorbidities – Non CC

4. UB-04 Claim Form

5. Field Locators

6. Field Locators for the UB-04

7. POA Indicator • 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

8. Field Locators – UB-04 Medicare Severity Adjustment DRGs FY 2008 IPPS Final Rule - August 1, 2007 Effective October 1, 2007 Major Complications and Comorbidities – MCC Complications and Comorbidities – CC Non Complications and Comorbidities – Non CC

9. Summary • We have gone through the data elements necessary for Submitting an Institutional Claim form • We have gone through individual data elements required for billing • We have discussed why information is necessary • We understand now where the data flows from

10. Questions Thank you for attending this session Any questions??