HOW TO USE THE “UB92” FORM

This specialized billing form requires some specific fields to be filled in for the patient. As long as these fields are populated, this form becomes fairly easy to use.

There are some special instructions for setting up the SOURCE TYPE for services so that the program will automatically select the correct description, revenue code, etc. In the Registry area (Basic System Information) use the pull down arrow to select the following table: UB92 Value codes and definitions. This will list out the source types that will be needed for each type of service. The CODE field is what is needed. For example

CODE VC#$V Value Codes and Descritpions

42 50 $ Physical Therapy Visits

43 51 # Occupational Therapy Visits

44 52 # Speech Therapy Visits

48 53 # Cardiac Rehabilitation Visits

55 56 # Skilled Nurse Home Visit Hours

There are many more on the list, these are just an example. So, for Physical Therapy, the source type in the services (or policy) area would need to be 42, Skilled Nursing a 55.

Special UB92 Fields

In the patient claims area click on the Visit Info/Misc tab. In the Upper Right corner you will see [Show UB92 Info] This button will open another screen with all of the fields needed to properly setup and fill out your UB92 Billing form.

Filling in these fields will enter data into the fields of the UB92 as marked above. Once you have entered the information needed for this claim, click on the [Hide UB92 Info…] to get back to the normal Visit Info/Misc tab of the claims screen.