HealthCare News

UB-04

Issue: #393 MAR2017

Topic: Coding/Billing


Physical Therapist and Occupational Therapist Billing Requirements

Physical Therapists (PT) and Occupational Therapists (OT) submitting therapy claims are required to enter the following information in Form Locators 77 and 78 or 79 of the UB-04 claim form.

For paper claims submission:

  • PT and OT information is reported in the Form Locator 77. Enter the 72 qualifier, the NPI and the First and Last Name of the primary PT or OT providing the services.
  • PT and OT information is reported in the Form Locator 78 or 79. Enter the ZZ qualifier, the NPI and the First and Last Name of the secondary, assisting PT or OT providing the services. Required when Operating Physician is involved.

For electronic claims submission:

  • The PT and OT information should be reported in the Operating Physician Loop 2310B (NM101 qualifier 72, NM102 qualifier 1, NM103 Last Name, NM104 First Name, NM108 qualifier XX, NM109 NPI) of the primary PT or OT providing the services.
  • The PT and OT information should be reported in the Other Operating Physician Loop 2310C (NM101 qualifier ZZ, NM102 qualifier 1, NM103 Last Name, NM104 First Name, NM108 qualifier XX, NM109 NPI) of the secondary, assisting PT or OT providing the services. Required when Operating Physician is involved.