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Update to UB-04 Claim Submissions: Type of Admission/Visit

Effective on and after February 14, 2018, print UB-04 claim submissions require the inclusion of one of the following values within the Type of Admission/Visit field (field 14).

Type of Admission/Visit Value Value Description
1 Emergency
2 Urgent
3 Elective
4 Newborn
5 Trauma
6-8 Reserved for assignment by the NUBC.
9 Information not available

UB-04 claims processed on and after February 14, 2018 that do not include a valid Type of Admission/Visit value will be rejected.

This change to our Optical Character Recognition (OCR) system processing logic is in accordance with the National Uniform Billing Committee (NUBC) UB-04 billing guidelines. Visit nubc.org and review the Official UB-04 Data Specifications Manual for detailed information.

This update also aligns how we process print UB-04 claims with the way we have been processing similar electronic claim submissions in regard to the Type of Admission/Visit field.

If a UB-04 claim is rejected for this reason, please submit a new claim with complete/correct information to the claims address noted on the back of your patient's Horizon BCBSNJ ID card.

If you have questions, please contact your Ancillary Contracting Specialist or Network Hospital Specialist.

If you would like information about submitting electronic claim transactions to us, please contact our EDI team at 1-888-334-9242 or via email at HorizonEDI@HorizonBlue.com

Published on: April 4, 2018, 13:13 p.m. ET
Last updated on: April 4, 2018, 14:23 p.m. ET