UB-04 Codes

UB-04 data files in TXT (Plain Text), CSV, and XLS (Excel) formats.
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What's included:

  • Single User Liscense to all official UB-04 codes
  • UB-04 code data files in TXT, CSV, and XLS formats

Multiple Users

If you need to purchase more than one user license, adjust the quantity added to the cart. For example, if you need five user licenses, set the quantity to 5 and add the codes to the cart. Alternatively, you can adjust the number of licenses in your shopping cart under the "Licenses" column.

For licensing purposes, an individual is a "User" if he or she directly accesses the data either in the original data file or through an application that has imported the data.  In the case where CPT is embedded in an application and not directly accessible, if the individual relies on the embedded data to perform his or her intended function with the application or its output, then they are also considered a user.

 

This data file includes all official UB-04 Codes.

Your BITSCodes subscription will include updates to the UB-04 Codes data if any, at no additional charge during the term of your subscription.

The UB-04 Code data file is raw data and is designed to be loaded into another application like the Free Medical Code ViewerMicrosoft Excel or a Practice Management Software Application that can open or import txt, csv, or xls files.

To provide maximum flexibility and ease of installation, the data file is supplied in the three most common formats: tab delimited (.txt), comma delimited (.csv), and Microsoft Excel format (.xls). Each record includes the CPT code, Description, facility RVUs and non-facility RVUs.

Below is a sample of the data you will receive:

UB-04 Condition Codes:

ConditionUsage ConditionCode Description                 
Insurance 01 Military service related (patient incurred medical condition during military services)          
Insurance 02 Condition is employment-related (patient alleges medical condition isdue to environment/events resulting from employment)      
Insurance 03 Patient covered by insurance not reflected here (patient or her/his representative has stated that coverage exists beyond that reflected on this bill)    
Insurance 04 Information-only bill (Medicare beneficiary is enrolled in a risk-based HMO and you expect to receive payment from the HMO; this code indicates that you are submitting a bill for information only)

 

UB-04 Newborn Source of Admission Codes:

Code Description
5 A baby born inside the hospital
6 A baby born outside of this hospital

 

UB-04 Occurence Codes:

Code Description    
01 Accident, auto/medical coverage  
02 No-fault insurance involved, including auto accident/other
03 Accident, tort liability   
04 Accident, employment related  
05 Accident/no medical or liability coverage 

 

UB-04 Occurence Span Codes:

Code Description
71 Prior stay dates 
72 First/last visit 
73 Benefit eligibility period

 

UB-04 Patient Status Codes:

Code Description
01 Discharged to home for self care (routine discharge)     
02 Discharged/transferred to a short-term general hospital for inpatient care   
03 Discharged/transferred to a skilled nursing facility (SNF) with Medicare certification in anticipation of skilled care
04 Discharged/transferred to an intermediate care facility (ICF)     

 

UB-04 Relationship Codes:

Code Description
01 Spouse
18 Self
19 Child

 

UB-04 Revenue Codes:

Code Description 
0240 All-Inclusive Ancillary General
0100 All-Inclusive Room & Board & Ancillary
0540 Ambulance 
0490 Ambulatory Surgical Care

 

UB-04 Revenue Numeric Codes:

Code Description    
0001 Total Charges    
0020 Health Insurance – Prospective Payment System (PPS)
0022 SNF – (PPS)    
0023 Home Health – PPS   
0024 Inpatient Rehab Facility – PPS  

 

UB-04 Source of Admission Codes:

Code Description UsageNote Inpatient Outpatient                   
1 Non-health care facility point of origin Usage note: Includes patients coming from home, a physician’s office, or workplace. Inpatient: The patient was admitted to this facility upon an order of a physician. Outpatient: The patient presents to this facility with an order from a physician for services or seeks scheduled services for which an order is not required (e.g., mammography). Includes non-emergent self-referrals.
2 Clinic   Inpatient: The patient was admitted to this facility as a transfer from a freestanding or non-freestanding claim. Outpatient: the patient was referred to this facility for outpatient or referenced diagnostic services.           
4 Transfer from a hospital Usage note: Excludes transfers from hospital inpatient in the same facility. Inpatient: The patient was admitted to this facility as a hospital transfer from an acute care facility where he or she was an inpatient or an outpatient. Outpatient: The patient was transferred to this facility as an outpatient from an acute care facility.           

 

UB-04 Type of Admission Codes:

Code Description                 
1 Emergency Required immediate medical intervention as a result of severe, life threatening, or potentially disabling conditions. (Generally, these patients are admitted through the emergency room.)
2 Urgent Required immediate attention for the care and treatment of a physical or mental disorder. (Generally, these patients are admitted to the first available and suitable accommodation.)
3 Elective Had a condition which permitted adequate time to schedule a suitable accommodation.         

 

UB-04 Type of Bill Codes:

TableType Code Description NextTable
M2 6 Intermediate Care – Level 11  
M2 8 Swing Beds    
M3 1 A Rural Health Clinic   
M3 2 A Hospital-based or Independent Renal Dialysis Cen  

 

UB-04 Value Codes:

Code Description Discontinued
01 Most common semi-private room rate False
02 Hospital has no semi-private rooms False
04 Professional component charges, which are combined billed False
05 Professional component included in charges and also billed separately to carrier False
06 Medicare blood deductible False
08 Medicare lifetime reserve amount (in the first calendar year) False
09 Medicare co-insurance amount (in the first calendar year in billing period) False
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