Instructions and guideline for CMS 1500 claim form and UB 04 form. Tips and updates. Detailed review of all the fields in CMS 1500 claim form and UB 04 form and ADA form. How to get the claim passed without denial and get the payment.
Entering a “Y”, if applicable, in the UNSHADED
section of this line or the corresponding field on the
electronic claim record indicates an emergency.
Emergency patients are exempt from a copayment.
If not an emergency, leave blank.