Ub92 And Ub04 Forms, What Is The Difference And Why Were There Changes?

It seems that with each changing year, there are smaller laptops coming out

, cameras with higher pixel count and a slew of other technological advances at our fingertips. The medical billing industry is no exception. The National Uniform Billing Committee (NUBC) is always on the lookout to upgrade and improve various outdated medical billing forms and systems.

Such is the case with the UB92 medical claim form. The UB92 form had been the standard medical insurance claim form used by health care organizations and hospitals to bill insurance and Medicaid payers. Back in 2007, the National Uniform Billing Committee officially retired the form, approving a revised version of the UB92 form known as the UB04 form. As of March 1, 2007 health plans, clearinghouses and providers were to be prepared to switch to the new form. But sometimes change is hard. While it's becoming increasingly difficult to find UB92 forms in both paper and electronic form, some institutions are still using them. Medicare and Medicaid are no longer accepting the UB92 form though. Software companies that provide electronic billing have pretty much phased out the use of the UB92, which means you can't submit it electronically for faster payment.

So what's the difference between the UB92 and the UB40 forms? A number of things were added to the UB92 form when it underwent the revision to become UB04. The main change is the addition of the field in which to input a National Provider Identifier (NPI). Additional fields were also added like more diagnosis code fields. Many of these same form changes occurred when the HCFA form was upgraded to become of the CMS 1500 claim form.

The CMS 1500 should not be confused with the UB04 form. The two forms are similar in many ways but the main difference is one is used by individual health providers and one is used by health institutions. Health institutions like hospitals and rehab clinics are required to submit their Medicare and Medicaid medical billing forms on the UB04 form. Individuals, such as private providers and single physicians are required to submit their Medicare and Medicaid medical billing forms in the on the CMS 1500 claim form, which was formerly known as the HCFA 1500 claim form.

In general, both the UB04 form and the CMS 1500 form are similar in the information that they ask for, including patient and provider information, payment information and details of treatment procedures. When using either form it is important to complete all fields and keep copies for the forms for recording purposes. A variety of software systems are available that can make filling out and submitting the UB04 easy and ensure faster payment times.

by: John V

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