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The most current specifications for the data elements and codes included on the UB-04 claim form and the electronic HIPAA Institutional 837 Health Care Claim transaction standard is available via the National Uniform Billing Committee's Official UB-04 Data Specifications Manual on the NUBC website. The following list is not all-inclusive: Providers shall report POA indicators to TRICARE in the same manner they report to the CMS, and in accordance with the UB-04 Data Specifications Manual, and ICD-10-CM Official Guidelines for Coding and Reporting. See the complete instructions in the UB-04 Data Specifications Manual for specific instructions and examples. The UB-04 claim form accommodates the National Provider Identifier (NPI) and has incorporated other important changes. Sample UB-04 forms for inpatient and outpatient claims can be found on pages 3 and 4. The UB-04 claim form and NPI The UB-04 claim form includes several fields that accommodate the use of your NPI. Although the form (4)(2) The Florida Workers' Compensation Health Care Provider Reimbursement Manual ("HCP RM"), incorporated by reference into Rules Rule 69L-7.020, F.A.C.; and Rules 69L-7.100 through 7.750, F.A.C. which inform Health Care Providers and Insurers of their respective responsibilities in the billing, filing, reporting and review of worker's compensation medical claims the Workers (89) The director adopts, by reference, the Official UB-04 Data Specifications Manual 2020 Edition, published by National Uniform Billing Committee (NUBC). To get a copy, contact the NUBC, American Hospital Association, 155 North Wacker Drive, Suite 400, Chicago, IL 60606, 312-422-3000, or nubc.org. (910) The director adopts, by reference Hospital outpatient clinic visits for assessment and management are billed with G0463. For a list of condition codes, occurrence codes, occurrence span codes, value codes, revenue codes and all other required data reported on the UB-04, please visit the NUBC website for the official UB-04 data specifications manual. This webpage is used to structure an article produced by CMS or Noridian. (8)The director adopts, by reference, the Official UB-04 Data Specifications Manual 2019 Edition, published by National Uniform Billing Committee (NUBC). To get a copy, contact the NUBC, American Hospital Association, 155 North Wacker Drive, Suite 400, Chicago, IL 60606, 312-422-3000, or nubc.org. 96360. Intravenous infusion, hydration; initial, 31 minutes to 1 hour. Do not report 96360 if performed as a concurrent infusion service. Do not report intravenous infusion for hydration of 30 minutes or less. 96361. Each additional hour (List separately in addition to code for primary procedure). Use 96361 in conjunction with 96360. UB-04 Manual. This product contains OFFICIAL UB-04 DATA SPECIFICATIONS MANUAL, content which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable, which was developed exclusively at private expense