We are seeing a higher volume of paper claims submitted without the appropriate values in required fields. Claims without the required values may not be routed correctly for processing, which will cause delays.
We encourage you to review the full list of required data fields outlined in the UB-04 claim submission guide and work with your billing department or third-party biller to confirm these billing requirements are enforced.
Example fields include:
38
| Responsible Party Name and Address
| Required, if applicable
| Required, if applicable
|
39-41
| Value Codes and Amounts
| Required, if applicable
| Required, if applicable
|
42
| Revenue Code
| Required
| Required
|
43
| Revenue Code Description
| Required
| Required
|
NDC Code
| Required, if applicable
| Required, if applicable
|
44
| HCPCS/Rates
| Required, if applicable
| Required, if applicable
|
45
| Service Date
| N/A
| Required
|
46
| Units of Service
| Required
| Required
|
47
| Total Charges (by Revenue Code)
| Required
| Required
|
48
| Non-Covered Charges
| Required, if applicable
| Required, if applicable
|
49
| Future Use
| N/A
| N/A
|
50
| Payer Name
| Required
| Required
|
51
| Health Plan ID
| Situational
| Situational
|
52
| Release of Information Certification
| Required
| Required
|
53
| Assignment of Benefit Certification
| Required
| Required
|
54
| Prior Payments
| Required, if applicable
| Required, if applicable
|
55
| Estimated Amount Due
| Required
| Required
|
56
| NPI
| Required
| Required
|
For
more information on billing, review the Claims
resources and guides page of our website.
25-0024