Radiology procedure on the UB 04 form. Billing Tips: When completing claims, do not enter the decimal points in ICD-9-CM codes or dollar amounts. If requested information does not fit neatly in the Remarks field (Box 80) of the claim, type it on an 8½ x...
This is an example only. Please adapt to your billing situation. In this case a clinic physician orders an eye socket X-ray, which is performed at and billed by the clinic. This claim example illustrates the billing of a bilateral radiographic procedure...
