2025 Uniform Billing Editor (Binder)
Optum | |
Facilities can use this reference tool daily to manage the constant changes in the Medicare billing and reimbursement process. The Uniform Billing Editor provides detailed, accurate, and timely information about Medicare and UB-04 billing rules and assists the user with 5010 data and UB-04 and 837i requirements.
- Quickly locate topics based on field locators, revenue codes, or coding structures. This easy-to-use format is fully indexed and tabbed with icons for quick reference.
- Quickly link HCPCS and CPT® codes to applicable revenue codes. This crosswalk helps you to prevent the most common reasons for rejections — mismatched revenue codes and CPT® or HCPCS Level II codes.
- Crosswalk to 837 institutional claims. Provides links to 837i 5010 data elements and any applicable billing rules — facilitating easier transition to the 837i.
- Coding and billing tips with quick access to official sources. Submit claims to Medicare accurately the first time — helps you reduce claim delays and denials.
- Includes 5010 standards and provides detailed, accurate, and timely information about Medicare billing and reimbursement.
- OCE and MCE edits. Identify data inconsistencies, potential rejections, and denials through OCE and MCE edits.
- Timely updates throughout the year. Stay current with changes to help you eliminate billing with outdated information.
Jaqueline Petersen, MHA, RHIA, CHDA, CPC
Ms. Petersen is a subject matter expert (SME) with Optum360. She has served as Senior Clinical Product Research Analyst with Optum360 developing business requirements for edits to support correct coding and reimbursement for claims processing applications. Her experience includes development of data-driven and system rules for both professional and facility claims and in-depth analysis of claims data inclusive of ICD-10-CM, CPT®, HCPCS and modifiers. Her background also includes consulting work for Optum, serving as a SME, and providing coding and reimbursement education to internal and external clients. Ms. Petersen is a member of the American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA).
CPT is a registered trademark of the American Medical Association.
CPT is a registered trademark of the American Medical Association.
Felicia Kolasi, CPC-I, CPC-CRCR, RH-CBS
Ms. Kolasi has more than 20 years of experience in the healthcare profession. She has served in a variety of roles including education, auditing, inpatient hospital coding, and physician and hospital outpatient coding. She has an extensive background in charge master, rural health coding and billing, professional component coding, medical record documentation improvement processes, HIPAA compliance, and has proven expertise in assignment of E/M codes. She also taught medical insurance, coding and billing, and (AAPC) PMCC curriculum at a local community college. Ms. Kolasi is an active member and is credentialed by the American Academy of Professional Coders (AAPC) and is an active member of ArchProCoding for Rural & Community Health.
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