tci General Surgery Coding Alert - 2014 Issue 9

Reader Question: Unravel UB-04 and CMS-1500 Differences

Question: I recently switched from billing for hospital outpatient surgeries to coding for a general surgery practice. Can you explain to me when a practice would use the CMS-1500 form instead of the UB-04? Maine Subscriber Answer: You shouldn’t need to use the UB-04 form in a private surgery practice. The definitions of the UB-04 and CMS-1500 are as follows: CMS -1500: The Form CMS-1500 is the standard paper claim form used by health care professionals and suppliers to bill Medicare Carriers or Part A/B and Durable Medical Equipment Medicare Administrative Contractors. Claims must be submitted within one...

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