Mich. Admin. Code R. 418.10922 - Hospital billing instructions
Rule 922.
(1) A
hospital shall bill facility charges on the UB-04 national uniform billing
claim form and shall include revenue codes, ICD-10-CM and ICD-10-PCS coding,
HCPCS codes, and CPT® procedure codes to identify the surgical,
radiological, laboratory, medicine, and evaluation and management services.
This rule only requires that the following medical records be attached when
appropriate:
(a) Emergency room
report.
(b) The initial evaluation
and progress reports every 30 days whenever physical medicine, speech, and
hearing services are billed.
(c)
The anesthesia record when billing for a CRNA, certified anesthesiologist
assistant, or anesthesiologist.
(2) A properly completed UB-04 shall not
require attachment of medical records except for those in subrule (1) of this
rule to be considered for payment. Information required for reimbursement is
included on the claim form. A carrier may request any additional records under
R 418.10118.
(3) If a hospital clinic, other than an
industrial or occupational medicine clinic, bills under a hospital's federal
employer identification number, then a hospital clinic facility service shall
be identified by using revenue code 510 "clinic."
(4) A hospital system-owned office practice
shall bill services on the CMS 1500 claim form using the office site of service
and shall not bill facility fees.
(5) A hospital or hospital system-owned
industrial or occupational clinic providing occupational health services shall
bill services on the CMS 1500 claim form using the office site of service and
shall not bill facility fees.
Notes
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