Suppressing Value Codes on UB Claims

Help Guide for NextGen® Enterprise PM 8

Setting Up Encounters for UB Claims

The following list outlines the areas of the Encounter Maintenance window that are important to the setup of UB claims: On the General tab, complete the Service Location field. On the UB tab, access the following sub-tabs: Condition Codes, Occurrence Codes, and Value Codes. Encounter Maintenance Note: For Enhanced UB users, the automated UB claims process only applies to payers who are considered primary. The automating of the Type of Bill field, the Occurrence codes, and the Value codes, which are explained in the following sections, only occurs for primary payers who have the required criteria. UB/General Tab UB/Condition Codes Tab UB/Occurrence Codes Tab UB/Value Codes Tab Setting Up Practice Preferences for UB Claims Parent topic: UB Claims

Help Guide for NextGen® Enterprise PM 8

Suppressing Value Codes on UB Claims

You can suppress value code entries on claims with the exception of FL39a - FL41a and FL39d - 41d. There are two ways to enable value code suppression: The UB/Value Codes tab on the Encounter Maintenance window allows the entry of value codes in any of the fields, FL39a through FL41d. Claim edit 210, Value codes out of sequence, generates a claim production status message if the value codes on an encounter are out of sequence. Parent topic: UB Claims

Help Guide for NextGen® Enterprise PM 8

UB Value Codes Sub-Tab

Value codes indicate the code and related dollar amounts that identify monetary data required for processing claims. This information is required for benefit determination. Value codes are two character alpha-numeric codes that print in Field Locators 39-41 on UB claims. You can modify the code and the dollar amount when specific codes and amounts are needed on the UB claim for the encounter. You can select one Value Code and associated Dollar Amount in rows 39a - 41d, or up to 12 codes and amounts per encounter. Example: When you select 21 (Catastrophic) in row 31a and enter a dollar amount, the condition code 21 and the amount display in field locator 39a on UB claim forms for the encounter. Note: A default Value Code may have been linked to the Revenue Code that prints in Field Locator #42 on UB claims for the service. The default is defined in File Maintenance > PM System Master Files > Revenue Codes. Parent topic: Encounter Maintenance - UB Tab

Help Guide for NextGen® Enterprise PM 8

UB Value Codes Sub-Tab

Value codes indicate the code and related dollar amounts that identify monetary data required for processing claims. This information is required for benefit determination. Value codes are two character alpha-numeric codes that print in Field Locators 39-41 on UB claims. You can modify the code and the dollar amount when specific codes and amounts are needed on the UB claim for the encounter. You can select one Value Code and associated Dollar Amount in rows 39a - 41d, or up to 12 codes and amounts per encounter. Example: When you select 21 (Catastrophic) in row 31a and enter a dollar amount, the condition code 21 and the amount display in field locator 39a on UB claim forms for the encounter. Note: A default Value Code may have been linked to the Revenue Code that prints in Field Locator #42 on UB claims for the service. The default is defined in File Maintenance > PM System Master Files > Revenue Codes. Parent topic: Encounter Maintenance - UB Tab

Help Guide for NextGen® Enterprise PM 8

Setting Up Encounters for UB Claims

The following list outlines the areas of the Encounter Maintenance window that are important to the setup of UB claims: On the General tab, complete the Service Location field. On the UB tab, access the following sub-tabs: Condition Codes, Occurrence Codes, and Value Codes. Encounter Maintenance Note: For Enhanced UB users, the automated UB claims process only applies to payers who are considered primary. The automating of the Type of Bill field, the Occurrence codes, and the Value codes, which are explained in the following sections, only occurs for primary payers who have the required criteria. UB/General Tab UB/Condition Codes Tab UB/Occurrence Codes Tab UB/Value Codes Tab Setting Up Practice Preferences for UB Claims Parent topic: UB Claims

Help Guide for NextGen® Enterprise PM 8

Value Codes

The value in the Value Code field in the Revenue Code master file is the default value for the value code field, 39a on the UB / Value Code tab of the Encounter Maintenance window. The box to the right of 39a displays a 1 to indicate a single encounter in the series. Parent topic: Viewing a Single Encounter After Billing

Suppressing Value Codes on UB Claims

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Setting Up Encounters for UB Claims

Suppressing Value Codes on UB Claims

UB Value Codes Sub-Tab

UB Value Codes Sub-Tab

Setting Up Encounters for UB Claims

Value Codes

Suppressing Value Codes on UB Claims

Setting Up Encounters for UB Claims

Suppressing Value Codes on UB Claims

UB Value Codes Sub-Tab

UB Value Codes Sub-Tab

Setting Up Encounters for UB Claims

Value Codes