UB-92 Screen to ANSI 837I Reference

To access this screen, click the Charges tab and click the UB-92 button. Service Line data must be entered before clicking the button.

The Type of Bill will automatically fill with the previously entered value.

Use the ‘Copy Previous Values’ button to copy the claims values (from the same patient only).

Type of Bill: Loop 2300-CLM-05

Patient Status: Loop 2300-CL1-03

Attending Phy: Loop 2310A-NM1 and REF segments. All the information is pulled from the Physician/Facility Library in the Tools menu. Simply select the name from the list.

Values Codes: Loop 2300-HI*BE

Admission Date: Loop 2300-DTP*435 Field 3

Admission Hour: Loop 2300-DTP*435 Field 4

Admission Type: Loop 2300-CL1-01

Admission Source: Loop 2300-CL1-02

Occurrence: Loop 2300-HI*BH