Must know how to complete a UB-04 claim form. Must know (ICD-10-CM)(CD-10-PCS codes). Download the attached files in adobe. One item is the actual case and one is the UB-04 claim form. I also attached the UB-04 Form Instructions if you need them. For this application assignment, you will code a patient encounter and create a paper ub-04 claim form. In order to complete this assignment, you will need to do the following:
- Review Case 002 and assign ICD-10-CM & ICD-10-PCS codes.
- Complete the UB-04 claim form for Case 002.