• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Form Question: 1500 vs. UB

nwnsc01

Guest
Messages
1
Best answers
0
Good morning everyone,

I'm new to coding/billing in general, and am looking for an answer to what probably amounts to a very basic question.

I'm trying to determine the difference between the CMS-1500 and UB-04 forms and under which circumstances you should use one over the other. My current understanding is that the CMS-1500 are used for billing physician's services, where as the UB-04 are used for billing facility charges (in an ASC for example).

Currently, we bill both our physicians services and our ASC facility charges on a 1500 form, and everything seems to be fine. I'm trying to figure out of there is a benefit to billing on a UB-04 for the ASC, instead of using the 1500? My initial guess is that we can bill for HCPCS-II codes on a UB, whereas we cannot do so on a 1500?

Also, on a semi-unrelated note, can anyone point me to a nice training manual for coding/billing in general? The experience I have now is based on my work experience, which results in a lot of 'the way we've always done it' knowledge, and I feel like I am missing some pertinent basic information. I purchased a few of the study guides from AAPC, such as their CASCC, but found they assume a higher level of experience than I currently have. I'm hoping I can find a nice comprehensive manual that will take me from step 1 of layman through becoming proficient and knowledgeable on the subject.

Thanks for your help!
 
Re: the books, you might consider taking a couple of courses at a local college or purchasing textbooks commonly used in college courses.

For billing, consider
Fordney, Insurance Billing for the Medical Office;
Beik, Health Insurance Today; or
Vines, Comprehensive Health Insurance.

For coding, consider
Buck, Step by Step Medical Coding;
Leon-Chisen, Faye Brown's ICD-9-CM Coding Handbook;
Schraffenberger, basic ICD-9-CM Coding;
Green, 3-2-1 Code It

A web search or Amazon search should turn up most of these.
I hope this helps.
 
Top