ub04 value codes field 39-41

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ub04 value codes field 39-41

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Elements of a Clean Claim – Magellan Provider's Home Page

Subscriber's address (street or P.O. Box, City, Zip Code) (field 7);. • Whether
patient's … Value code and amounts (fields 39-41);. • Revenue code (field 42);.

UB-04 User Guide – Blue Cross and Blue Shield of New Mexico

Blue Shield of New Mexico offers this guide for completion of the UB-04 form for
your … P.O. Box 27630 …. Committee's Official UB-04 Data Specifications Manual
. … 39-41. VALUE CODES AND AMOUNT. Enter the appropriate two-digit value …

IHS/638 PROVIDER MANUAL – AHCCCS

Dec 1, 2014 … NOTE: This chapter applies to paper CMS 1500, UB-04, and ADA claims
submitted to AHCCCS. …. Relate the service provided to the diagnosis code(s)
listed in Field 21 by entering the letter of the …. 39-41 Value Codes and Amounts
… *Effective 07/01/2016 NDC information will be Required if applicable.

UB04 Hospital Billing Instructions and Matric Revenue Code

Oct 1, 2015 … FL 39-41. Value Codes and Amounts. 38. FL 42. Revenue Codes …. The UB-04
is a uniform institutional bill suitable for use in billing multiple third …. The “x” in
the Type of Bill column of the matrix represents a placeholder for …

Inside IPP – Summer 2015 – Independence Blue Cross

coming in 2016. Use full member ID … CMS-1500 claim form, or the equivalent
field of the 837 professional. (loop 2420G) … When the UB-04 claim form is used
for … shall populate Form Locators 39-41 with Value Code “A0” and the five-digit
 …

91 – Kymmis.com

Jul 10, 2015 … Created CORF own billing manual. Broke out from … Add field 66 to the detailed
billing instructions for. ICD indicator. ….. 6.1 UB-04 Claim Form with NPI and
Taxonomy . ….. Frankfort, KY 40602-2016 ….. 39-41. Value Codes. Enter the
appropriate value code(s) for Medicare/Medicaid crossover claims.

August Provider Bulletin – Blue Cross of Northeastern Pennsylvania

Aug 1, 2015 … UB-04 or Box 21 of the NUCC 1500 claim form. …. Populate Form Locators 39-41
, Code A0 (Special ZIP code …. Occurrence Span Codes and Dates … Prior to
march 2016, applicable medicaid claims submitted without these.

Changes Come to the Health Network Services Team – Blue Cross …

manual in the Provider section at nebraskablue.com. …. Enter your “First Name”
and “Last Name” in the name fields. Step 3: Click ….. Prior to March 2016,
applicable Medicaid claims submitted …. Form locators 39-41. Up to 12 … (UB04)
(4). Value code. Not applicable for professional claim. Loop 2300 HI in second
position …

PT91 v1.0 – Finance and Administration Cabinet

Apr 15, 2014 … Created CORF own billing manual. Broke out ….. 6.2 Completion of UB-04 Claim
Form with NPI and Taxonomy . ….. P.O. Box 2016 ….. 39-41. Value Codes. Enter
the appropriate value code(s) for Medicare/Medicaid crossover.

Fourth Quarter – Blue Cross and Blue Shield of Montana

… January 1, 2016. On January 1, 2016, the Blue Cross and Blue Shield of
Montana (BCBSMT) ….. voicemail box. A representative will ….. Form Locators 39
-41. Up to 12 value …. Official UB-04 Data Specifications Manual 2015. Version
9.00.



AARP health insurance plans (PDF download)

Medicare replacement (PDF download)

AARP MedicareRx Plans United Healthcare (PDF download)

AARP life insurance (PDF download)

medicare benefits (PDF download)

medicare healthcare (PDF download)

medicare part b (PDF download)



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