Mich. Admin. Code R. 418.10925 - Billing requirements for other licensed facilities
Rule 925.
(1) A
licensed facility, other than a hospital or freestanding surgical outpatient
facility, shall bill the facility services on the UB-04 national uniform
billing claim form and shall include the revenue codes contained in the
Official UB-04 Data Specifications Manual, ICD-10-CM and ICD-10-PCS coding for
diagnoses and procedures, and CPT procedure codes for surgical, radiological,
laboratory, and medicine and evaluation and management services.
(2) Only the technical component of a
radiological service or a laboratory service shall be billed on the
standardized UB-04 national uniform billing claim form.
(3) All bills for the professional services
shall be billed on a CMS 1500 claim form, using the appropriate CPT procedure
code and modifier.
(4) A report
describing the services provided and the condition of the patient shall be
included with the bill.
Notes
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