How do I bill a newborn claim?
The newborn’s services and hospital stay are billed on a second claim separate from the mother’s claim. All newborn claims will use an admit type “4” (newborn) for healthy babies (revenue code 170 or 171) and an admit type “1” (emergency) for a sick baby (revenue codes 172, 173 or 174).
What are UB-04 claims?
UB-04 (also known as the CMS-1450): The UB-04 is the claim form for institutional facilities, and includes the following: Hospitals. Rehab facilities, e.g. physical therapy, occupational therapy and speech therapy. General health centers, federal health centers and rural clinics.
What are Nicu revenue codes?
The NICU levels of care are based on the complexity of care that a newborn with specified diagnoses and symptoms requires. All four levels of care are represented by a unique revenue code: Level 1/0171, Level 2/0172, Level 3/0173 and Level 4/0174.
What is the time limit for UB-04 claim?
within six months
Original Medi-Cal or California Children’s Services (CCS) claims must be received by the California Medicaid Management Information System (California MMIS) Fiscal Intermediary within six months following the month in which services were rendered. This requirement is referred to as the six-month billing limit.
Is newborn care covered under mother insurance?
Although newborn babies are covered under their mother’s health insurance policy for the first 30 days, not every mother has health insurance.
What is birthday rule in medical billing?
The birthday rule is a method used by health insurance companies to determine which parent’s health insurance coverage is the primary insurance for a dependent child, when both parents have separate coverage.
What is revenue Code 250?
There are several ways revenue code 250 can be used for billing outpatient medications. The first pertains to billing for a covered medication which does not have a valid HCPCS or CPT code. In this instance, revenue code 250 may be billed without a corresponding code.
What is revenue Code 122?
Revenue Code Description. 112. Room & Board: Private – OB. 122. Room & Board: Semi-Private 2 Beds – OB.
How are covered and non covered Days reported on ub04?
All inpatient claims must report the covered and non-covered days. This must be done using value codes 80 and 81 (Form Locator 39 – 41; Loop 2300 HI -Value Information: H101-2-H112-2 (value code), H101-5-H112-5 (value amount)). the left of the dollars/cents delimiter.
What is Box 42 on ub04?
Box 42 – Revenue Code: (Required) For General Hospitals, please use the appropriate revenue code(s) in a 4 digit format with a leading zero.