UB Value Codes Sub-Tab

Help Guide for NextGen® Enterprise PM 8

UB Occurrence Codes Sub-Tab

Occurrence Codes define specific events relating to a bill that may affect payer processing. This is a two character alpha-numeric code that prints in Field Locators 31 - 34 on the UB claims form. You can select one Occurrence Code and Date for field locators 31a - 34b, or up to eight (8) codes and dates per encounter. Example: When you select 01 (Auto Accident) in row 31a and enter a date, the condition code 01 and the date display in field locator 31 on UB claim forms for the encounter. If the 01 (Auto Accident) occurrence code is linked to revenue code 369 Auto Accident Catastrophic, then 369 prints in the field locator box. Note: When an Occurrence Code is linked to a Revenue Code, the default Revenue Code prints on the UB form in the field locator box. The default is defined in File Maintenance > System Master Files > PM > Revenue Codes. 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

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

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/Value Codes Tab

UB Each field on the UB / Value Codes tab is labeled with a number (39, 40, or 41) followed by a letter (a, b, c, or d). The value codes that are entered in these fields will have an associated dollar amount or unit value associated with it that is entered in the field to the right of the numbered fields. When a value code is entered in one of the numbered fields and you tab to the associated field to the right, the application automatically converts the field to accept a dollar value or a unit value. If a dollar value is the required entry, the field displays with $0.00. If a unit value is the required entry, the field displays blank. All the fields on this tab correspond to the Field Locators on the UB claim form. For example, the value code and associated dollar amount or unit value that is entered in the 39a field will populate the first line, which is considered line a, of Field Locator 39 on the UB04 claim form. Field 39b would correspond with the second line, which is line b, of

Help Guide for NextGen® Enterprise PM 8

Add or Modify Revenue Codes for Encounter Rate Billing

Encounter rate payers that are billed on UB/837I claims require a four-digit revenue code in Field Locator 42 for each line item on the claim. Therefore, a revenue code must be attached to all SIM codes in the Service Items library that may be billed on a UB/837I claim. Note: The Revenue Codes master file in File Maintenance is pre-installed. Items should be reviewed and modified as needed. To add or modify a revenue code for encounter rate billing, do the following: Access File Maintenance. Select System Master Files, then PM, and then Revenue Codes. The Revenue Codes List window opens. Do one of the following: To add a revenue code, select Open Menu and select New. To modify a revenue code, select the code from the list, and then select Open Menu and select Open. The Add/Modify Revenue Code Information window opens. In the Code field, enter the four-digit revenue code. This field is required. In the Description field, enter a descriptive name for the revenue code. This field is requi

UB Value Codes Sub-Tab

Recommendations

UB Occurrence Codes Sub-Tab

UB Condition Codes Sub-Tab

UB General Sub-Tab

Encounter Maintenance - UB Tab

UB/Value Codes Tab

Add or Modify Revenue Codes for Encounter Rate Billing

UB Occurrence Codes Sub-Tab

UB Condition Codes Sub-Tab

UB General Sub-Tab

Encounter Maintenance - UB Tab

UB/Value Codes Tab

Add or Modify Revenue Codes for Encounter Rate Billing