Monday December 01, 2008
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Purchase UB-04 Forms

Full color paper proofs of the UB-04 form are available from:

Purchase The Official UB-04 Manual

The Official UB-04 Data Specifications manual is available from the National Uniform Billing Committee (NUBC).  Cost is $150/year for a printable electronic manual or an electronic version with updates. Click here to download the request form and then send to address below:

  • American Hospital Association, National Uniform Billing Committee, P.O. Box 92247, Chicago, IL  60675-2247
CMS Manual: Publication 100-04 Medicare Claims Processing

Chapter 25 UB-04 Instructions

UB Instruction Manual

UB-92 Handbook for Hospital Billing and/or UB-04 Handbook for Hospital Billing:

Go to: www.aha.org Go to Red Banner, half way down the page and look for SERVICES. Click on AHA ONLINE STORE. Go to SEARCH box & type BIRKENSHAW or BILLING

Revised 1500 Claim Form

Go to the National Uniform Claim Committee website : www.nucc.org

Additional EDI Information

Go to the Washington Publishing Company website: www.wpc-edi.com

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