Use only the physical address for the service facility location field. Include National Provider Identifier (NPI) information where indicated. More detailed instructions can be found at www.cms.gov or www.nubc.org . There are 81 fields or lines on a UB-04.
Include National Provider Identifier (NPI) information where indicated. More detailed instructions can be found at www.cms.gov or www.nubc.org . There are 81 fields or lines on a UB-04. They're referred to as form locators or "FL." Each form locator has a unique purpose:
An itemized medical bill lists in detail all the services that were provided during a visit or stay—such as a blood test or physical therapy—and may be sent to the patient directly. The UB-O4 form is used by institutions to bill Medicare or Medicaid and other insurance companies. What is the difference between the UB-04 and the CMS 1500 forms?
There are 81 fields or lines on a UB-04. They're referred to as form locators or "FL.". Each form locator has a unique purpose: Form locator 1: Billing provider name, street address, city, state, zip, telephone, fax, and country code.
The UB-04 uniform medical billing form is the standard claim form that any institutional provider can use for the billing of inpatient or outpatient medical and mental health claims. It is a paper claim form printed with red ink on white standard paper. Although developed by the Centers for Medicare ...
What is the difference between the UB-04 and the CMS 1500 forms? The UB-04 form is used by institutional providers, such as nursing homes and hospitals, while the CMS-1500 form is the standard claim form used by a non-institutional provider or supplier, such as a physician or a provider of durable medical equipment. 2.