UB/Condition Codes Tab

Help Guide for NextGen® Enterprise PM 8

UB/Condition Codes Tab

Condition codes indicate a set of conditions that apply to a bill that impact how a UB claim is processed. You can enter the codes on the Encounter Maintenance > UB tab. The codes you select control what displays on the printed claim form and populate the HI*BG segment of the 837I electronic claim. Note: You can modify the condition code descriptions in the Code Tables list in File Maintenance. Parent topic: Setting Up Encounters for 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

Encounter Maintenance - UB Tab

The UB tab includes information about the patient’s encounter that may be needed on electronic 837I or paper UB claims for the encounter. Note: This tab displays only if the default Type of Facility and Bill Classification options have been enabled in the Claims preferences under Practice Preferences. The UB tab has the following sub-tabs: General Condition Codes Occurrence Codes Value Codes UB General Sub-Tab UB Condition Codes Sub-Tab UB Occurrence Codes Sub-Tab Occurrence Codes define specific events relating to a bill that may affect payer processing. You can select one Occurrence Code and Date for field locators 31a - 34b, or up to eight (8) codes and dates per encounter. UB Value Codes Sub-Tab Value codes indicate the code and related dollar amounts that identify monetary data required for processing claims. You can modify the code and the dollar amount when specific codes and amounts are needed on the UB claim for the encounter. Parent topic: Encounter Maintenance

Help Guide for NextGen® Enterprise PM 8

Encounter Maintenance - UB Tab

The UB tab includes information about the patient’s encounter that may be needed on electronic 837I or paper UB claims for the encounter. Note: This tab displays only if the default Type of Facility and Bill Classification options have been enabled in the Claims preferences under Practice Preferences. The UB tab has the following sub-tabs: General Condition Codes Occurrence Codes Value Codes UB General Sub-Tab UB Condition Codes Sub-Tab UB Occurrence Codes Sub-Tab Occurrence Codes define specific events relating to a bill that may affect payer processing. You can select one Occurrence Code and Date for field locators 31a - 34b, or up to eight (8) codes and dates per encounter. UB Value Codes Sub-Tab Value codes indicate the code and related dollar amounts that identify monetary data required for processing claims. You can modify the code and the dollar amount when specific codes and amounts are needed on the UB claim for the encounter. Parent topic: Encounter Maintenance

Help Guide for NextGen® Enterprise PM 8

UB Condition Codes Sub-Tab

Condition codes indicate a set of conditions that apply to a bill that can affect processing and payment of the claim. This two-digit code can indicate many different reasons that will affect claim processing such as: if a claim is employment related, a non-terminal condition for Hospice, or a private room is medically necessary. You can select one Condition Code for field locators 18 - 28, or up to ten (11) codes per encounter. Example: When you select 02 (Condition is Employment Related) in row 18, the condition code 02 displays in field locator 18 on UB claim forms for the encounter. Parent topic: Encounter Maintenance - UB Tab

Help Guide for NextGen® Enterprise PM 8

UB Condition Codes Sub-Tab

Condition codes indicate a set of conditions that apply to a bill that can affect processing and payment of the claim. This two-digit code can indicate many different reasons that will affect claim processing such as: if a claim is employment related, a non-terminal condition for Hospice, or a private room is medically necessary. You can select one Condition Code for field locators 18 - 28, or up to ten (11) codes per encounter. Example: When you select 02 (Condition is Employment Related) in row 18, the condition code 02 displays in field locator 18 on UB claim forms for the encounter. Parent topic: Encounter Maintenance - UB Tab

UB/Condition Codes Tab

Recommendations

UB/Condition Codes Tab

Setting Up Encounters for UB Claims

Encounter Maintenance - UB Tab

Encounter Maintenance - UB Tab

UB Condition Codes Sub-Tab

UB Condition Codes Sub-Tab

UB/Condition Codes Tab

UB/Condition Codes Tab

Setting Up Encounters for UB Claims

Encounter Maintenance - UB Tab

Encounter Maintenance - UB Tab

UB Condition Codes Sub-Tab

UB Condition Codes Sub-Tab