nazcoder
Networker
Greetings everyone;
Our facility was recently granted FQHC Status and now comes claim submission
Per Field Locators and field entry on the UB-04 for electronic submission, can someone please verify if the following fields are correct? We are outpatient providing outpatient physician services only.
TOB = 0771
Admission Type = 3
Admission source = blank
Patient Status = 01 (Discharge to Home)
Revenue Code = 0521
Do I need the following on the UB-04?
Attending Provider
Admit and Discharge Date
Any other fields?
I thank and appreciate any and all responses. I went through CMS and it does not seem really clear on UB-04 claim submission in regards to FQHC Claims. I may be looking at the wrong place too inside CMS. Thank you all. Have a good day.
Our facility was recently granted FQHC Status and now comes claim submission
Per Field Locators and field entry on the UB-04 for electronic submission, can someone please verify if the following fields are correct? We are outpatient providing outpatient physician services only.
TOB = 0771
Admission Type = 3
Admission source = blank
Patient Status = 01 (Discharge to Home)
Revenue Code = 0521
Do I need the following on the UB-04?
Attending Provider
Admit and Discharge Date
Any other fields?
I thank and appreciate any and all responses. I went through CMS and it does not seem really clear on UB-04 claim submission in regards to FQHC Claims. I may be looking at the wrong place too inside CMS. Thank you all. Have a good day.