UB Occurrence Codes Sub-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

UB General Sub-Tab

The General sub-tab in the UB tab includes the following fields: Field Description Type of Bill This field contains three fields; one for each character of a three-digit code on UB claims. The default digits for all encounter are defined on the Claims tab in Practice Preferences. You can modify them if different digits are needed on the UB claim for the encounter. Hold Date This option puts a hold on the claim. It is used by Medicare but can be used by other providers as well. It stops the creation of a claim until the hold date ends, currently not used. Source of Admission Select from the list the actual source of the admission. For example, a clinical referral or a law enforcement. It prints in Field Locator #15 on UB claims. You can select from: 1 - Clinic Referral 8 - Court/Law Enforcement 7 - Emergency Room 3 - HMO Referral 9 - Information Not Available 1 - Physician Referral 6 - Transfer from Another Facility 4 - Transfer from Hospital A - Transfer from RPCH 5 - Transfer from SNF

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

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/Occurrence Codes Tab

UB All the fields on UB > Occurrence Codes correspond to the Field Locators on the UB claim form. For example, the occurrence code and date that is entered in the 32a field will populate the first line, which is considered line a, of Field Locator 32 on the UB claim form. Field 32b would correspond with the second line, which is line b, of Field Locator 32 on the UB claim. Note: All entries must be added starting with 32A before 33A can be added. The following example shows the top half of a UB04 claim form with lines a and b of the occurrence code fields. The UB > Occurrence Codes is used differently, depending on the type of user. If you are a Regular UB user, you can use the fields on this tab to manually enter the occurrence codes and dates that you want to print on the UB claim. Select the drop-down menu to display the list of occurrence codes. The occurrence codes and dates that are entered in these fields must be entered in the order that the fields display on the window. When o

Help Guide for NextGen® Enterprise PM 8

Occurrence Codes

The value in the Onset Date field on the Encounter Maintenance window is the default value for the first occurrence code field, 31a. The value in the Occurrence Code field in the Revenue Code master file is the default value for the second occurrence code field, 32a on the UB / Occurrences Codes tab of the Encounter Maintenance window. This code is the starting date of treatment for the series. The encounter date is the default value for this occurrence code. Parent topic: Viewing a Single Encounter After Billing

UB Occurrence Codes Sub-Tab

Recommendations

UB Value Codes Sub-Tab

UB General Sub-Tab

UB Condition Codes Sub-Tab

Encounter Maintenance - UB Tab

UB/Occurrence Codes Tab

Occurrence Codes

UB Value Codes Sub-Tab

UB General Sub-Tab

UB Condition Codes Sub-Tab

Encounter Maintenance - UB Tab

UB/Occurrence Codes Tab

Occurrence Codes